Radiotherapy methods, systems, and workflow-oriented graphical user interfaces

ABSTRACT

Disclosed herein are radiotherapy methods and systems that can display a workflow-oriented graphical user interface(s). A method comprises presenting a plurality of pages for display, each corresponding to a stage of a radiotherapy treatment for a patient; in response to receiving an indication that a surface of a patient is aligned, retrieving, from a radiotherapy file, a first image of an internal target aligned in accordance with treatment attributes; receiving a second image of the internal target; overlaying on a first page of the plurality of pages, the first image and the second image, the first page displaying a direction to position the internal target in the second image to align with the internal target in the first image; and when the internal target is aligned, presenting for display a second page of the plurality of pages corresponding to a subsequent stage of the radiotherapy treatment for the patient.

TECHNICAL FIELD

This application relates generally to graphical user interfaces andsoftware for radiotherapy treatments and machines.

BACKGROUND

Radiation therapy, which is the use of ionizing radiation, is alocalized treatment for a specific target tissue, such as a canceroustumor. Ideally, radiation therapy is performed on target tissue (alsoreferred to as the planning target volume or the target organ) thatspares the surrounding normal tissue from receiving doses abovespecified tolerances, thereby minimizing risk of damage to healthytissue. So that the prescribed dose is correctly supplied to theplanning target volume during radiation therapy, the patient should beprecisely positioned relative to the linear accelerator that providesthe radiation therapy, typically using a movable treatment couch mountedon a turntable assembly.

Therefore, implementing the radiation therapy is a complex process thatcontains specific guidelines, protocols and instructions adopted andobserved by different medical professionals, such as theclinicians/technicians, the manufacturers of the medical device, thetreating physicians, and the like. Due to the above-described hazardsassociated with radiation emitted from the radiotherapy (also referredto as radiation therapy) machine, it is imperative that all theinstructions are precisely followed.

Conventional radiation therapy systems can be complex to operate, andusers generally require extensive training to perform the variousworkflows on the system efficiently. For instance, patient positioning,system calibration, and other adjustments of the machine and/oraccessories typically involve various interactions with and adjustmentsof the patient and the radiotherapy machine. Because data needed to setup the machine and/or the patient is voluminous and complicated,conventional methods typically display the data on a screen within thetreatment room. However, conventional methods/system can be inefficient,ineffective, or even dangerous.

As depicted in FIG. 1B, the information needed by an operator (e.g.,radiotherapy technician) is typically displayed on a screen that isusually placed on a wall near the radiotherapy machine or on anothermonitor within the treatment room. As a result, when the operatorfocuses on the display screen, the operator must turn away from thepatient and the radiotherapy machine. The process of adjusting theradiotherapy machine and/or the patient is interrupted by shifting thefocus away from the radiotherapy machine and/or the patient. Theinconvenient placement of the display screen has been proven to beineffective and time-consuming.

Furthermore, conventional radiotherapy systems do not provide anefficient manner of displaying the data needed for the operator to setup the patient and/or the radiotherapy machine. For instance,conventional radiotherapy systems display all the information needed toimplement a patient's radiotherapy treatment on a screen at one time.Referring to FIGS. 1C-D, two examples of conventional graphical userinterfaces (GUIs) displaying radiation therapy data is presented. Asdepicted, these GUIs are static and difficult to understand and follow.Furthermore, these GUIs display data that is not necessarily needed at aparticular stage of the machine or patient set up. Therefore, bydisplaying all radiotherapy data at once, these GUIs have createdinefficiencies. As a result, unless an operator is very experienced witha particular radiation therapy system, utilization of the system willnot be maximized, which slows set up of the system and degrades theradiation therapy experience of the patient.

Furthermore, a typical radiation therapy system usually involves aspecific sequence of user inputs selected from this multiplicity ofinput mechanisms. Consequently, when performing a radiation therapyworkflow, selecting the correct input button or switch from among thedozens of possible input mechanisms available can be problematic andtime-consuming. Conventional methods also allow operators to interactwith the radiotherapy system (e.g., adjust the radiotherapy machine)using a controller (sometimes referred to as a pendant) connected to theradiotherapy machine. Referring now to FIG. 1E, an example of aconventional pendant is presented. As depicted, the pendant depicted inFIG. 1E has many input mechanisms (e.g., buttons and switches) whereeach input mechanism is specific to different parameters and attributesof the radiotherapy system. Therefore, conventional pendants arecomplicated and require the operators to be familiar with many inputmechanisms, resulting in errors and inefficiencies.

Finally, most radiotherapy systems require a secondary operator tomonitor the radiotherapy machine and patient set up from a differentroom other than the treatment room using console monitor(s). In someconfigurations, the same operator (from the treatment room) may need tomonitor the radiotherapy machine and patient set up from a differentroom. Typically, the operator leaves the treatment room before thepatient's treatment begins to avoid exposure to radiation. Therefore,there is a need to monitor the patient and/or the radiotherapy machinefrom a secondary location that shields the operator from radiation (alsoreferred to as a console room). FIG. 1F is an example of a monitoringstation in a secondary location. Conventional console monitor(s) provideradiotherapy machine and patient data. Because the data being monitoredis voluminous, conventional console monitor(s) display the data onmultiple display screens. For instance, one monitor may displayparameters and one monitor may display a view of the patient. Asdepicted, multiple monitors display information about the radiotherapymachine and/or patient. The operator may focus on several screens tosafely and effectively monitor the patient in the treatment room.Monitoring data simultaneously displayed on multiple screens isdifficult and has led to inefficiencies. Further, the operator may haveseveral input mechanisms (e.g., buttons, switches, mouse, and keyboard)where each input mechanism is specific to different parameters andattributes of the radiotherapy machine. Therefore, the monitoringstation may require one or more experienced operators familiar with theinput mechanisms and the location of relevant information on the variousconsole monitors.

SUMMARY

For the aforementioned reasons, there is a desire for aworkflow-oriented graphical user interface(s) that displays thetreatment data (e.g., machine parameters, patient alignment data, andaccessories needed) in an efficient way. The methods and systemsdescribed herein provide graphical user interface having a series ofinterconnected pages that segment the data based on different treatmentstages and only show data relevant to a particular stage and relevant tothe patient's treatment. A central server can control theworkflow-oriented series of pages based on inputs received from thetechnician. The pages can be displayed on one or more electronic devicesdescribed herein (e.g., directly on a gantry), allowing the technicianto operate the radiotherapy machine without diverting attention awayfrom the patient.

Moreover, there is a desire to control a workflow-oriented graphicaluser interface using a pendant that is easy to use. Described herein aredifferent embodiments of a pendant that can be used in conjunction withthe workflow-oriented series of pages where the pendant can control theradiotherapy machine and navigate various pages described herein.

Furthermore, there is a desire for a console monitoring system that usesa series of interconnected pages that segment the data based ondifferent treatment stages and/or the actions performed within thetreatment room.

In an embodiment, a method comprises presenting, by a server, agraphical user interface for display on a screen associated with aradiotherapy machine, wherein the graphical user interface contains apage corresponding to one or more stages of radiotherapy treatment forthe patient, and transitioning, by the server, the graphical userinterface from a first page representing a first stage to a second pagerepresenting a second stage provided that at least a predeterminedportion of tasks associated with the first stage has been satisfied.

In another embodiment, a system comprises: a server comprising aprocessor and a non-transitory computer-readable medium containinginstructions that when executed by the processor causes the processor toperform operations comprising: present a graphical user interface fordisplay on a screen associated with a radiotherapy machine, wherein thegraphical user interface contains a page corresponding to one or morestages of radiotherapy treatment for the patient, and transition thegraphical user interface from a first page representing a first stage toa second page representing a second stage provided that at least apredetermined portion of tasks associated with the first stage has beensatisfied.

In another embodiment, a method comprises retrieving, by a server,information from a radiotherapy file associated with a patient, theinformation comprising an alignment data of at least a treatment regionof the patient; presenting, by the server, for display on a graphicaluser interface, an image corresponding to the patient positioned on acouch of a radiotherapy machine, the image comprising an overlay on asurface of the patient in the treatment region; and presenting, by theserver, for display, a visually distinct revised overlay for at least aportion of the surface of the patient in the treatment region thatmatches, within a predetermined margin of error, the alignment data.

In another embodiment, a system comprises a server comprising aprocessor and a non-transitory computer-readable medium containinginstructions that when executed by the processor causes the processor toperform operations comprising: retrieve information from a radiotherapyfile associated with a patient, the information comprising an alignmentdata of a treatment region of the patient; present for display on agraphical user interface, an image corresponding to the patientpositioned on a couch of a radiotherapy machine, the image comprising anoverlay on a surface of the patient in the treatment region; and presentfor display a visually distinct revised overlay for at least a portionof the surface of the patient in the treatment region that matches,within a predetermined margin of error, the alignment data.

In another embodiment, a method comprises presenting, by a server, fordisplay on a graphical user interface, an image of a position of apatient on a couch of a radiotherapy machine, whereby at least a gantryof the radiotherapy machine is configured to rotate around the patient;calculating, by the server, one or more predicted collisions between apart of the radiotherapy machine and at least one of (a) the patient or(b) another part of the radiotherapy machine; and when a portion of thepatient is calculated to be in a collision with the part of theradiotherapy machine, revising, by the server, the graphical userinterface such that the portion of the patient calculated to be in thecollision is visually distinct in the image.

In another embodiment, a system comprises a server comprising aprocessor and a non-transitory computer-readable medium containinginstructions that when executed by the processor causes the processor toperform operations comprising: present for display on a graphical userinterface an image of a position of a patient on a couch of aradiotherapy machine, whereby at least a gantry of the radiotherapymachine is configured to rotate around the patient; calculate one ormore predicted collisions between a part of the radiotherapy machine andat least one of (a) the patient or (b) another part of the radiotherapymachine; and when a portion of the patient is calculated to be in acollision with the part of the radiotherapy machine, revise, thegraphical user interface such that the portion of the patient calculatedto be in the collision is visually distinct in the image.

In another embodiment, a method comprises retrieving, by one or moreservers, a radiotherapy file associated with a patient, the radiotherapyfile comprising information associated with one or more accessoriesassociated with the patient's radiation therapy treatment; presenting,by one or more servers, for display on the graphical user interface, agraphical indicator corresponding to each of the one or moreaccessories; scanning, by one or more servers, a set of accessorieswithin a predetermined proximity to the radiotherapy machine; and whenthe server does not detect one or more of the one or more accessories inproximity to the radiotherapy machine or when one or more of the one ormore accessories is not within a predetermined location, revising, byone or more servers, the graphical indicator corresponding to thataccessory.

In another embodiment, a system comprises one or more servers comprisinga processor and a non-transitory computer-readable medium containinginstructions that when executed by the processor causes the processor toperform operations comprising: retrieve a radiotherapy file associatedwith a patient, the radiotherapy file comprising information associatedwith one or more accessories associated with the patient's radiationtherapy treatment; present for display on the graphical user interface,a graphical indicator corresponding to the each of the one or moreaccessories; scan a set of accessories within a predetermined proximityto the radiotherapy machine; and when the server does not detect one ormore of the one or more accessories in proximity to the radiotherapymachine or when one or more of the one or more accessories is not withina predetermined location, revise the graphical indicator correspondingto that accessory.

In another embodiment, a method comprises presenting, by a server, agraphical user interface for display on a screen positioned on a gantryof a radiotherapy machine, wherein the graphical user interfacecomprises a page corresponding to radiotherapy treatment of a patient,wherein the page comprises a first graphical element indicating at leastone attribute of the alignment data corresponding to the radiotherapytreatment of the patient.

In another embodiment, a system comprises a server comprising aprocessor and a non-transitory computer-readable medium containinginstructions that when executed by the processor causes the processor toperform operations comprising: present a graphical user interface fordisplay on a screen associated with a radiotherapy machine, wherein thegraphical user interface comprises a page corresponding to radiotherapytreatment of a patient, wherein the page comprises a first graphicalelement indicating at least one attribute of the alignment datacorresponding to the radiotherapy treatment of the patient.

In another embodiment, a method comprises presenting, by server fordisplay on a screen associated with a radiotherapy machine, a series ofconsecutive graphical user interfaces, wherein a first graphical userinterface within the series of consecutive graphical user interfacescomprises: a first graphical indicator corresponding to a firstattribute associated with configuration of the radiotherapy machine, anda second graphical indicator corresponding to a second attributeassociated with the patient; when the server receives an indication thata user interacting with a pendant having a processor in communicationwith the server has inputted a first input corresponding to a firstdirection towards the first graphical indicator, displaying, by theserver on the gantry, a second graphical user interface comprising dataassociated with the first attribute; and when the server receives anindication that a user interacting with the pendant has inputted asecond input corresponding to a second direction towards the secondgraphical indicator, displaying, by the server on the gantry, a thirdgraphical user interface comprising data associated with the secondattribute.

In another embodiment, a system comprises a server comprising aprocessor and a non-transitory computer-readable medium containinginstructions that when executed by the processor causes the processor toperform operations comprising: present for display on a screenassociated with a radiotherapy machine, a series of consecutivegraphical user interfaces, wherein a first graphical user interfacewithin the series of consecutive graphical user interfaces comprises: afirst graphical indicator corresponding to a first attribute associatedwith configuration of the radiotherapy machine, and a second graphicalindicator corresponding to a second attribute associated with thepatient; wherein when the server receives an indication that a userinteracting with a pendant having a processor in communication with theserver has inputted a first input corresponding to a first directiontowards the first graphical indicator, display on the gantry, a secondgraphical user interface comprising data associated with the firstattribute; and wherein when the server receives an indication that auser interacting with the pendant has inputted a second inputcorresponding to a second direction towards the second graphicalindicator, display a third graphical user interface comprising dataassociated with the second attribute.

In another embodiment, a pendant having a processor in communicationwith a radiotherapy machine and a computer, the pendant comprises afirst controller configured to adjust at least one configuration of theradiotherapy machine; and a second controller configured to receive aninput from a user, whereby when the computer receives the input, thecomputer revises a graphical user interface displayed on a gantry of theradiotherapy machine.

In another embodiment, a method comprises presenting, by the server fordisplay on a screen associated with a radiotherapy machine, a series ofconsecutive graphical user interfaces, wherein each graphical userinterface displays one or more graphical components corresponding to oneor more tasks of one or more stages of a patient's radiotherapytreatment; and when a user operating the pendant interacts with a firstcontroller of the pendant, the radiotherapy machine adjusts at least oneof its configurations; and when the user interacts with a secondcontroller of the pendant, the server revises the graphical userinterface corresponding to the user's input.

In another embodiment, a system comprises a server comprising aprocessor and a non-transitory computer-readable medium containinginstructions that when executed by the processor causes the processor toperform operations comprising: display on a screen associated with aradiotherapy machine, a series of consecutive graphical user interfaces,wherein each graphical user interface displays one or more graphicalcomponents corresponding to one or more tasks of one or more stages of apatient's radiotherapy treatment; and when a user actuates a firstcontroller of the pendant, the radiotherapy machine adjusts at least oneof its couch or gantry; and when the user actuates a second controllerof the pendant, the server revises the graphical user interfacecorresponding to the user's input.

In another embodiment, a system comprises a radiotherapy machinecomprising: a couch; and a gantry having a camera in communication witha server, wherein the server is configured to: present for display, inreal time on a screen associated with the radiotherapy machine, imagesreceived from the camera, wherein when the gantry changes itsorientation, the camera revises at least one of its orientations, suchthat images transmitted to the server maintain an original orientation.

In another embodiment, a method comprises presenting, by a server, fordisplay a graphical user interface on a screen associated with aradiotherapy machine, presenting, by the server, for display real timeimages received from a camera positioned on a gantry of the radiotherapymachine; when the gantry changes its orientation, revising, by theserver, in real time, at least one orientation of an image received fromthe camera, such that images displayed on the graphical user interfacemaintain an original orientation.

In another embodiment, a method for displaying on a radiotherapyconsole, the method comprises presenting, by a server, a first page of afirst graphical user interface on the radiotherapy console associatedwith a radiotherapy machine in a treatment room, wherein the firstgraphical user interface contains a plurality of pages, each pagecorresponding to a stage of treatment implemented by the radiotherapymachine, and the first page corresponds to a first stage; andtransitioning, by the server, the first page of the first graphical userinterface to a second page of the first graphical user interfacecorresponding to a second stage responsive to an input of a userinteracting with a second graphical interface presented on a display inthe treatment room indicating that at least a predetermined portion oftasks associated with the first stage has been satisfied.

In another embodiment, a radiotherapy system comprises a radiotherapymachine in a treatment room having a display; a radiotherapy consoledisplay outside the treatment room; and a server communicable with theradiotherapy machine and the radiotherapy console display, the serverconfigured to present a first graphical user interface associated withthe radiotherapy machine on the radiotherapy console display, whereinthe first graphical user interface contains a plurality of pages, eachpage corresponding to a stage of treatment implemented by theradiotherapy machine, a first page corresponds to a first stage, andwherein the first graphical user interface transitions the first page ofthe first graphical user interface to a second page of the firstgraphical user interface corresponding to a second stage responsive toan input of a user interacting with a second graphical interfacepresented on the display in the treatment room indicating that at leasta predetermined portion of tasks associated with the first stage hasbeen satisfied.

In another embodiment, a method comprises presenting, by a server, aplurality of pages for display, each page corresponding to a stage of aradiotherapy treatment for a patient; in response to receiving anindication that a surface of a patient is aligned, retrieving, by theserver, from a radiotherapy file of a patient a first image of aninternal target of the patient aligned in accordance with one or moretreatment attributes; receiving, by the server, a second image of theinternal target of the patient on a couch of a radiotherapy machine;overlaying, by the server, on a first page of the plurality of pages,the first image and the second image, wherein the first page displays adirection to position the internal target in the second image to alignwith the internal target in the first image; and when the internaltarget is aligned, presenting, by the server, for display, a second pageof the plurality of pages corresponding to a subsequent stage of theradiotherapy treatment for the patient.

In another embodiment, a system comprises a server comprising aprocessor and a non-transitory computer-readable medium containinginstructions that when executed by the processor causes the processor toperform operations comprising: presenting a plurality of pages fordisplay, each page corresponding to a stage of a radiotherapy treatmentfor a patient; in response to receiving an indication that a surface ofa patient is aligned, retrieve from a radiotherapy file of a patient afirst image of an internal target of the patient aligned in accordancewith one or more treatment attributes; receive a second image of theinternal target of the patient on a couch of a radiotherapy machine;overlay on a first page of the plurality of pages, the first image andthe second image, wherein the first page displays a direction toposition the internal target in the second image to align with theinternal target in the first image; and when the internal target isaligned, present for display, a second page of the plurality of pagescorresponding to a subsequent stage of the radiotherapy treatment forthe patient.

In another embodiment, a system comprises a first display incommunication with a server, the first display configured to display afirst graphical user interface; a second display in communication withthe server, the second display configured to display a second graphicaluser interface, wherein the server is configured to: present the firstgraphical user interface for displaying on the first display, whereinthe first graphical user interface contains one or more pagescorresponding to one or more stages of a radiotherapy treatment, whereinthe server transitions from a first page of the one or more pagesrepresenting a first stage to a second page of the one or more pagesrepresenting a second stage responsive to an indication that at least apredetermined portion of tasks associated with the first stage has beensatisfied.

In another embodiment, a method comprises displaying, by a server, afirst graphical user interface on a first display; displaying, by theserver, a second graphical user interface on a second display;presenting, by the server, the first graphical user interface fordisplay on the first display, wherein the first graphical user interfacecontains one or more pages corresponding to one or more stages of aradiotherapy treatment, and wherein the server transitions from a firstpage of the one or more pages representing a first stage to a secondpage of the one or more pages representing a second stage responsive toan indication that at least a predetermined portion of tasks associatedwith the first stage has been satisfied.

In another embodiment, a system comprises a radiotherapy machinecomprising: a gantry having a screen in communication with a server, thescreen configured to display a graphical user interface; and at leastone camera, wherein the server is configured to: present, in real time,images received from the at least one camera for display on a graphicaluser interface displayed on the screen.

In another embodiment, a method comprises presenting, by a server, agraphical user interface for display on a screen on a gantry of aradiotherapy machine; and presenting, by the server, in real time,images received from at least one camera for display on a graphical userinterface displayed on the screen of the gantry.

BRIEF DESCRIPTION OF THE DRAWINGS

Non-limiting embodiments of the present disclosure are described by wayof example with reference to the accompanying figures, which areschematic and are not intended to be drawn to scale. Unless indicated asrepresenting the background art, the figures represent aspects of thedisclosure.

FIG. 1A illustrates components of a workflow-oriented radiotherapysystem, according to an embodiment.

FIG. 1B illustrates conventional methods of displaying radiotherapydata, according to an embodiment.

FIGS. 1C-D illustrate conventional methods of displaying data needed toimplement a patient's radiotherapy, according to an embodiment.

FIG. 1E illustrates a conventional pendant for a radiotherapy system,according to an embodiment.

FIG. 1F illustrates conventional console monitors, according to anembodiment.

FIG. 2A illustrates a diagram of a radiotherapy machine used in aworkflow-oriented radiotherapy system, according to an embodiment.

FIGS. 2B-2G illustrate a radiotherapy machine used in aworkflow-oriented radiotherapy system, according to an embodiment.

FIG. 3A illustrates a diagram of a pendant used in a workflow-orientedradiotherapy system, according to an embodiment.

FIG. 3B illustrates a pendant used in a workflow-oriented radiotherapysystem, according to an embodiment.

FIG. 4A illustrates a flow diagram executed in a workflow-orientedradiotherapy system, according to an embodiment.

FIGS. 4B-4P illustrate pages displayed in a workflow-orientedradiotherapy system, according to an embodiment.

FIG. 5A illustrates a flow diagram executed in a workflow-orientedradiotherapy system, according to an embodiment.

FIGS. 5B-5C illustrate pages displayed in a workflow-orientedradiotherapy system, according to an embodiment.

FIG. 6A illustrates a flow diagram executed in a workflow-orientedradiotherapy system, according to an embodiment.

FIGS. 6B-6G illustrate pages displayed in a workflow-orientedradiotherapy system, according to an embodiment.

FIG. 7A illustrates a flow diagram executed in a workflow-orientedradiotherapy system, according to an embodiment.

FIGS. 7B-7C illustrate pages displayed in a workflow-orientedradiotherapy system, according to an embodiment.

FIG. 8 illustrates a flow diagram executed in a workflow-orientedradiotherapy system, according to an embodiment.

FIG. 9 illustrates a flow diagram executed in a workflow-orientedradiotherapy system, according to an embodiment.

FIG. 10A illustrates a diagram of a console monitor used in aworkflow-oriented radiotherapy system, according to an embodiment.

FIGS. 10B-10D illustrate console monitors used in a workflow-orientedradiotherapy system, according to an embodiment.

FIG. 11A illustrates a flow diagram executed in a workflow-orientedradiotherapy system, according to an embodiment.

FIGS. 11B-11N illustrate pages displayed in a workflow-orientedradiotherapy system, according to an embodiment.

FIG. 12A illustrates a flow diagram executed in a workflow-orientedradiotherapy system, according to an embodiment.

FIG. 12B illustrates a page displayed in a workflow-orientedradiotherapy system, according to an embodiment.

DETAILED DESCRIPTION

Reference will now be made to some embodiments illustrated in thedrawings, and specific language will be used here to describe the same.It will nevertheless be understood that no limitation of the scope ofthe embodiments of the methods and systems described herein is therebyintended. Alterations and further modifications of the featuresillustrated here, and additional applications of the principles of theembodiments of the methods and systems described herein as illustratedhere, which would occur to a person skilled in the relevant art andhaving possession of this disclosure, are to be considered within thescope of the embodiments, methods, and/or systems described herein.

System Architecture

The methods described herein can be implemented using various computingdevices/features described in FIG. 1A. Therefore, FIG. 1A describes anon-limiting example of a computer environment where a server canperform the processes/methods described herein, such as retrieving,processing, and presenting treatment data, and presenting data for agraphical user interface (GUI) having workflow-oriented pages (orinstances) on different displays screens.

FIG. 1A illustrates various components of a system 100 for presentingvarious pages related to operation of a radiotherapy treatment, inaccordance with an embodiment. The system 100 may include an analyticsserver 110, a medical records database 120, a radiotherapy system 140,console monitor(s) 150 (shown in the example embodiment as twomonitors), and a system administrator computer or workstation 160. Thesefeatures may communicate with each other over a network 130. Forexample, the system 100 may present, via the analytics server 110, aseries of workflow-oriented pages on the radiotherapy machine 141 and/orconsole monitors 150. In another example, the system 100 may present,via the analytics server 110, a page overlaid on a live feed of apatient to the radiotherapy machine 141 and/or console monitors 150.

The network 130 may include wired and/or wireless communicationsaccording to one or more standards via one or more transport mediums.Communication over the network 130 may be in accordance with variouscommunication protocols, such as transmission control protocol andinternet protocol (TCP/IP), user datagram protocol (UDP), and Instituteof Electrical and Electronics Engineers (IEEE) communication protocols.The network 130 may further include wireless communications according toBluetooth specification sets, or another standard or proprietarywireless communication protocol. The network 130 may further includecommunications over a cellular network, including, for example, a globalsystem for mobile (GSM) communications, code division multiple access(CDMA), and enhanced data for global evolution network (EDGE). Theexamples of the network 130 may include, but are not limited to, privateor public local area network (LAN), wireless LAN (WLAN), metropolitanarea network (MAN), wide area network (WAN), and the Internet.

The analytics server 110 may be any computing device capable ofperforming the actions described herein. For instance, the analyticsserver 110 includes a processing unit and a non-transitorymachine-readable storage medium. The processing unit includes aprocessor with a computer-readable medium, such as a random accessmemory coupled to the processor. The analytics server 110 executesalgorithms or computer executable program instructions, which may beexecuted by a single processor or multiple processors in a distributedconfiguration. The instructions allow the processor to implement thefunctionality described herein. The analytics server 110 may beconfigured to interact with one or more software modules of a same or adifferent type operating within the system 100.

Non-limiting examples of the processor may include a microprocessor, anapplication specific integrated circuit, and a field programmable objectarray, among others. The analytics server 110 may be capable ofexecuting data processing tasks, data analysis tasks, and valuationtasks. Non-limiting examples of the analytics server 110 may include adesktop computer, a server computer, a laptop computer, a tabletcomputer, and the like. For simplicity, the FIG. 1A depicts asingle-server computing device functioning as the analytics server 110.However, some embodiments may include a plurality of server computingdevices capable of performing various tasks described herein.

Implementation of the methods described herein is not limited to thesystem architecture depicted in FIG. 1A. In alternative embodiments, theanalytics server 110 may be an embedded computing device disposed withinthe radiotherapy machine 141. In some embodiments, the analytics server110 may be an embedded computing device disposed within the consolemonitors 150 or disposed within the system administrator computer 160.In some embodiments, the analytics server 110 may be a plurality ofcomputing devices operated locally and/or remotely. In variousembodiments, the analytics server 110 may be operated through a cloudservice (e.g., network, internet). The cloud service may be performed inaccordance with various communication protocols such as TCP/IP, UDP, andIEEE communication protocols.

The analytics server 110 may utilize a database, such as a localdatabase 111, to store and/or retrieve various data described herein.For instance, the analytics server 110 may store different datacorresponding to the different pages within the local database 111. Thepage may be displayed on a display screen associated with theradiotherapy system 140 and/or the console monitors 150.

For instance, the analytics server 110 may display a page having a livefeed of the patient before the treatment has begun or may displayvarious pages describing how to position the patient on the couch and/orhow to adjust the radiotherapy machine 141. Even though some embodimentsdescribe the analytics server 110 displaying various pages on a displayscreen attached to the radiotherapy machine 141 (e.g., located on thegantry of the radiotherapy machine 141), it is expressly understood thatthe analytics server 110 may display different pages described herein ona display screen located anywhere within the treatment room, such aslocated on the wall of the treatment room or on any electronic devicewithin the treatment room. In some configurations, the analytics server110 may display the pages on the system administrator computer orworkstation 160.

The local database 111 may also store data corresponding to theradiotherapy machine 141 (e.g., default position of the radiotherapymachine 141, current position of the radiotherapy machine 141, such asthe orientation of the bed/couch and gantry).

If the analytics server 110 receives a request from the radiotherapysystem 140 and/or the console monitors 150 to provide the currentposition/orientation of the radiotherapy machine 141, the analyticsserver 110 may query the local database 111 and may be retrieve thecorresponding data. Additionally, or alternatively, the analytics server111 may also communicate with various sensors associated with theradiotherapy system 140 to retrieve machine data and parameters. Theanalytics server 110 may then use the methods/systems described hereinto instruct the radiotherapy machine 141 to adjust the positioning ofthe radiotherapy machine 141 to the default positon of the radiotherapymachine 141 or another position of the radiotherapy machine, or todisplay one or more pages instructing a technician to adjust theradiotherapy machine 141 and/or the patient.

The local database 111 may also store data associated with differentusers of the radiotherapy system 140. In a non-limiting example, theuser data may include the user's login (e.g., sign-in, credentials)information and authorization levels. For example, the analytics server110 may store, using the local database 111 may store, the user's nameand password. The analytics server 110 may allow the user to log in tothe radiotherapy machine 141, the console monitors 150, and/or thesystem administrator computer 160. If the user logs-in into the system,the analytics server 110 may adjust what the user is able to view,adjust, and control based on the user's authorization level. Forexample, if a medical technician were to sign-in to the console monitors150 the analytics server 110 may only allow the medical technician tosee the treatment plan. The analytics server 110 may conceal thepatient's medical information that is not relevant to the radiationtreatment from the medical technician. In another example, the analyticsserver 110 may conceal all of the patient's medical information if amachine technician signs-in.

The analytics server 110 may also utilize one or more other databases,such as the medical records database 120, to store and/or retrievevarious data described herein. The databases herein can be configured asone or more databases storing the data, and the disclosure is notintended to be limited to a particular number or location of databases.The analytics server 110 may instruct the medical records database 120to store patient data (e.g., patient name, patient machine alignmentinformation) associated with a patient identifier (e.g., patient's name,patient's profile image). The analytics server 110 may then instruct themedical records database 120 to populate a dataset corresponding to apatient and display the profile image of the patient. If the analyticsserver 110 receives a request from the console monitors 150 and/or theradiotherapy system 140 to display the data associated with the patientidentifier, the analytics server 110 may query the medical recordsdatabase 120 and may retrieve the corresponding dataset. The analyticsserver 110 may then use the methods/systems described herein todynamically display the patient data in accordance with the patientidentifier.

The medical records database 120 may also include a radiotherapytreatment (RT) file associated with the patient identifier. As usedherein, the RT file refers to all data associated with a patient'sradiation therapy treatment and is not limited to a particular step orinformation. The RT file may also be retrieved from the radiotherapysystem 140, the console monitors 150, the database 120, and/or thesystem administrator computer 160. The RT file may include the treatmentdata associated with a patient. The RT file may be associated with apatient identifier and may also be updated after a patient has completedtreatment. For example, after the patient has completed a treatmentsession, the medical records database 120 may retrieve the duration ofthe treatment session from the radiotherapy system 140 and update theradiotherapy file to include the duration of the treatment session. Eventhough aspects of the embodiments descried herein discuss RT as a file,the RT file represents a collection of the patient's medical andtreatment data, which may be stored in different files. For brevity, thepresent disclosure refers to the patient's data as a RT file.

The RT file may include data for treatment plans for one or morepatients where each treatment plan is specific to a single patient. Forinstance, each treatment plan is uniquely created for each patient andcorresponds to the patient's unique attributes (e.g., physicalattributes of the patient and the patient's unique condition to betreated). In some configurations, each treatment plan for each patientmay itself include multiple files.

The analytics server 110 may retrieve treatment data associated with apatient that is stored within the patient's RT file(s). As describedherein, the analytics server 110 may analyze the treatment data and maydisplay various features and graphical components described herein.While the medical record database 120 may contain treatment data (RTfiles) associated with multiple patients, the methods described hereinare implemented such that various pages and graphical features describedherein are specific to the particular patient being treated.

In some configurations, the analytics server 110 may retrieve RT filesassociated with multiple patients. The analytics server 110 may thenreceive a selection by an operator (e.g., technician) of a patient to betreated. As a result, the analytics server 110 identifies the RT fileassociated with the selected patient and customizes the graphicalcomponents described herein for the selected patient.

The analytics server 110 may also retrieve and instruct the medicalrecords database 120 to store patient data associated with the patientfrom the medical records database 120, the radiotherapy system 140, theconsole monitors 150, and/or the system administrator computer 160. Forinstance, the medical records database 120 may include patient data(e.g., previously populated by the analytics server 110 and/orperiodically retrieved from a third-party data source). If a patient isselected, the analytics server 110 may query and retrieve patient datafrom the medical records database 120 and provide the retrieved patientdata to the console monitors 150. For instance, the analytics server 110may display the patient's profile image when the patient is selected,providing an opportunity to verify the correct patient was selected. Anon-limiting example of the analytics server 110 illustrating examplepatient identifiers is depicted in FIG. 4C.

The analytics server 110 may receive treatment data associated with apatient from the medical records database 120, the treatment data mayfurther include at least a patient identifier. The analytics server mayreceive RT file associated with one or more patients from the medicalrecords database 120. The RT file may refer to a file having dataassociated with a process in which a medical team (e.g., radiationoncologists, radiation therapist, medical physicists, and/or medicaldosimetrists) plan the appropriate external beam radiotherapy orinternal brachytherapy treatment techniques for a patient. The datawithin the RT file is not limited to the external radiation therapy asother treatments may impact the radiation therapy, such as medicaloncology treatment (chemotherapy), interventional oncology treatment(e.g. cryotherapy, microwave therapy, or embolic therapy) or othernon-treatment procedures, such as labs and appointments with othermedical professionals. The RT file may include data specific to one ormore patient's radiotherapy treatment. In some configurations, theanalytics server 110 may receive treatment data associated with apatient from the console monitors 150, treatment machine 140, or systemadministrator computer 160.

The RT file may include a patient identifier, patient's electronichealth data records, medical images (e.g., CT scans, 4D CT Scans, Mills,and x-ray images), treatment-specific data (e.g., arc information ortreatment type), target organ (e.g., specification and location data toidentify the tumor to be eradicated), treatment plan, etc. Additionalexamples may include non-target organs, dosage-related calculations(e.g., radiation dose distribution within an anatomical region of thepatient), and radiotherapy machine specific information (e.g.,couch-gantry orientations, machine trajectory, control points, dosedistributions, and/or arc information).

The analytics server 110 may use the patient identifier within the RTfile to identify a particular patient and retrieve additionalinformation regarding said patient. For instance, the analytics server110 may query the medical records database 120 to identify medical dataassociated with the patient. For instance, the analytics server mayquery data associated with the patient's anatomy, such as physical data(e.g., height, weight, and/or body mass index) and/or otherhealth-related data (e.g., blood pressure or other data relevant to thepatient receiving radiotherapy treatment). The analytics server 110 mayalso retrieve data associated with current and/or previous medicaltreatments received by the patient (e.g., prior treatment fractions, ordata associated with the patient's previous surgeries).

The analytics server 110 may analyze the data received and generateadditional queries accordingly. For instance, the analytics server 110may retrieve data associated with one or more medical (or other) devicesneeded for the patient. The analytics server may retrieve dataindicating that the patient suffers from a respiratory medicalcondition. As a result, the analytics server 110 may generate andtransmit a query to the radiotherapy machine 141, the console monitors150, or the system administrator computer 160 to identify whether thepatient uses/needs a ventilator.

If necessary, the analytics server 110 may also analyze the patient'smedical data records to identify the needed patient attributes. Forinstance, the analytics server 110 may query a database to identify thepatient's BMI. However, because many medical records are notdigitalized, the analytics server 110 may not receive the patient's BMIvalue using simple query techniques. As a result, the analytics server110 may retrieve the patient's electronic health data and may executeone or more analytical protocols (e.g., natural language processing) toidentify the patient's body mass index. In another example, if theanalytics server 110 does not receive tumor data (e.g., end-points) theanalytics server 110 may execute various image recognition protocols andidentify the tumor data.

Another example of a patient attribute may include specific tumorlocations. More specifically, this data may indicate the primary tumorlocation with respect to the patient's centerline. This data may beinputted by the treating oncologist or may be analyzed using variousimage recognition or segmentation methods executed on the patient'smedical images.

Another example of a patient attribute may include whether the patientuses prosthesis (e.g., hip or femoral head prosthesis). This attributemay result in a change of the patient's treatment (e.g., patients withthese conditions might require a special treatment).

The analytics server 110 may use various application-programminginterfaces (APIs) to communicate with different features describedherein. As used herein, an API refers to a computing interface that usesconnector programming code to act as a software intermediary between atleast two computing components/features described herein. The API mayautomatically and/or periodically transfer various calls, instructions,and/or requests among different features of the system 100. Usingdifferent APIs, the analytics server 110 may automatically transmitand/or receive calls and instructions. For instance, the analyticsserver 110 may use an API to communicate with the network 130 such thatwhen an end user (e.g., system administrator or technician) operatingthe console monitors 150 requests a particular patient information, theAPI automatically transmits an instruction to the radiotherapy system140. The instruction may include data needed for the analytics server110 to generate and display the pages described herein. The analyticsserver 110 may also use the API to communicate with the local database111 (e.g., retrieve the set of prompts).

The analytics server 110 may also use the API to transmit a second callto the network 130. The second call may include instructions to displaythe generated pages (e.g., software code defining the pages andinstructing the network 130 to embed the pages within the radiotherapysystem 140). As the network 130 displays the pages, the analytics server110 may use the API to receive inputs from the technician. The analyticsserver 110 may then aggregate the inputs and use the API to transmit theaggregated responses to the radiotherapy system 140. The analyticsserver may similarly use a two-way API to communicate with the medicalrecords database 120.

Additionally, or alternatively, the analytics server 110 may use acontent delivery network (CDN) to ensure data integrity whencommunicating with different features described in the system 100. Asdescribed herein, a CDN refers to a distributed delivery network ofproxy servers/nodes that uses multi-layered delivery methods/systems totransmit data (e.g., Akamai). The analytics server 110 may use a CDNwhen communicating various calls/instructions with the network 130and/or the local database 111.

The radiotherapy system 140 may include a radiotherapy machine 141 and apendant 142. The radiotherapy machine 141 may be located in thetreatment room. As discussed in greater detail herein, the radiotherapymachine 141 may be controlled locally using a computer/processorassociated with the radiotherapy machine and/or by the pendant 142. Theradiotherapy machine 141 may also be instructed by the analytics server110 outside of the treatment room, by the console monitors 150, and/orthe system administrator computer 160. For example, the technician maypower on the radiotherapy machine 141 using a page located on theconsole monitors 150. The radiotherapy machine 141 may also communicatewith the medical records database 120 to retrieve and/or store patientdata.

The radiotherapy machine 141 may also include a couch to align thepatient in a designated position before the treatment begins. Thedesignated position may be identified, calculated, and/or retrieved bythe analytics server 110. For example, the analytics server 110 mayretrieve patient data from the medical records database 120, analyze thedata, and utilize the analyzed data to position the patient on thecouch. In some embodiments, the doctor identifies how to align thepatient on the couch to optimize the treatment therapy. The radiotherapymachine 141 directs radiation at specified locations of the patientresting on the couch during treatment. The specified locations may beselected by the technician operating the radiotherapy machine 141, thependant 142, the console monitors 150, and/or the system administratorcomputer 160. The analytics server 110 may also specify the locations onthe patient to direct the radiation.

The radiotherapy machine 141 may also include an x-ray emitter and anx-ray receiver. The x-ray emitter may be disposed on a gantry of theradiotherapy machine 141 and may be configured to provide x-ray (e.g., apenetrating form of high-energy electromagnetic radiation) waves. Thex-ray emitter emits x-ray waves to the patient who is positioned on thecouch. The x-ray receiver may be disposed opposed to the x-ray emitter.The x-ray waves received by the x-ray receiver generate an imprint(e.g., image) of the patient's internal anatomy. Although the exampleembodiment recites the use of x-ray imaging, an alternativeconfiguration for the radiotherapy machine may include an additional orother medical imaging apparatus (e.g., fluoroscopy apparatus, Mill,etc.).

The radiotherapy machine 141 may also include a set of cameras (e.g.,camera on an end of the couch, gantry camera, ceiling camera, or othercameras placed within the radiotherapy room). The analytics server 110may retrieve a live feed of the couch (e.g., with or without thepatient) from the set of cameras and provide it to a display screendisposed on the radiotherapy machine 141 and/or the console monitors150. The set of cameras may also directly communicate with theradiotherapy system 140.

The radiotherapy machine 141 may also include a gantry that may be incommunication with the analytics server 110. If the radiotherapy machine141 is in operation, the gantry may rotate relative to the radiotherapymachine 141 to begin the treatment of the patient. The analytics server110 may use the live feed of the set of cameras to control and/or stopthe movement of the gantry. During operation, the analytics server 110may instruct the display screen of the radiotherapy machine 141 todisplay the live feed of the set of cameras and/or a designated page tothe display screen of the radiotherapy machine 141. In variousembodiments, the analytics server 110 may not instruct the displayscreen of the radiotherapy machine 141 to activate the display screen ofthe radiotherapy machine 141 during operation. In some embodiments, thedisplay screen of the radiotherapy machine 141 may be a touch screen andmay control the pages generated by the analytics server 110 through thedisplay screen of the radiotherapy machine 141.

The radiotherapy machine 141 may have a default home position. Beforethe patient receives treatment, the radiotherapy machine 141 may bereset to a position that is ergonomically desirable for the patient. Thedefault home position may also be optimized to receive a new patient orallow the patient to more easily get off the couch.

As discussed in greater detail herein, the radiotherapy machine 141 mayalso be controlled by the pendant 142. The pendant 142 may be connectedto the radiotherapy machine 141 through wired or wireless communicationsaccording to, for example, Bluetooth specification sets or anotherstandard or proprietary wireless communication protocol. In variousembodiments, the pendant 142 may be connected to the radiotherapymachine 141 through a wired connection or be integrated into theradiotherapy machine 141. The pendant 142 may also be in communicationwith the analytics server 110. The pendant 142 may adjust thepositioning of the radiotherapy machine 141 through a selection ofbuttons that axially actuates the radiotherapy machine 141 (e.g., couch)towards a desired direction. The technician may also use the pendant 142to initialize the radiotherapy machine 141, and/or to have theradiotherapy machine 141 return to its home position.

The pendant 142 may also allow the technician to input patientinformation, which may be then communicated to the radiotherapy machine141, the analytics server 110, the console monitors 150, and/or themedical records database 120. The pendant 142 may be used to control oneor more of the steps of the setup and treatment of the patient.

The pendant 142 may also include a touch pad (e.g., tactile sensor). Thetouch pad may be used to control various pages generated by theanalytics server 110. For example, the user may use the touch pad of thependant 142 to control a page, generated by the analytics server 110, toproceed through the workflow steps of the radiotherapy treatment. Insome embodiments, the page may be controlled through a touch screen onthe radiotherapy machine 141 or elsewhere in the treatment room.

As discussed in greater detail herein, the radiotherapy system 140 mayfurther include accessories that assist in the treatment of the patient.The analytics server 110 may communicate with the radiotherapy system140 to select which accessories are required. The analytics server 110may also communicate with the medical records database 120, the consolemonitors 150, and/or the system administrator computer 160 to determinewhich accessories are required. For example, a patient may require aspecific accessory for their treatment. The analytics server 110 mayretrieve that the patient requires a specific accessory by accessing themedical records database 120 and communicate that information to theradiotherapy system 140. The accessories may in communication with theradiotherapy system 140. For instance, as will be described below, theanalytics server may use RFID tags to scan and identify the locationand/or presence of various accessories. In some embodiments, theaccessories are wired or otherwise integrated into the radiotherapymachine 141.

As discussed in greater detail herein, the console monitors 150 may be acomputing device including a processing unit. The processing unit mayexecute a software that accesses or receives data records from themedical records database 120 and/or the local database 111. Theprocessing unit may include a processor with computer-readable medium,such as a random access memory coupled to the processor. The consolemonitors 150 may be running algorithms or computer executable programinstructions, which may be executed by a single processor or multipleprocessors in a distributed configuration. The console monitors 150 mayinteract with one or more software modules of a same or a different typeoperating within the system 100.

Non-limiting examples of the processor may include a microprocessor, anapplication specific integrated circuit, and a field programmable objectarray, among others. Non-limiting examples of the console monitors 150may include a server computer, a workstation computer, a tablet device,and a mobile device (e.g., smartphone, PDA). The technician may operatethe console monitors 150 (e.g., by inputting the patient data oradjusting the radiotherapy machine 141). For simplicity, FIG. 1Aillustrates a single computing device functioning as the consolemonitors 150. However, some embodiments may include a plurality ofcomputing devices capable of performing the tasks described herein. Insome embodiments, the console monitors 150 may be located outside of thetreatment room.

The local database 111 associated with the analytics server 110, themedical records database 120, the radiotherapy machine 141, and theconsole monitors 150 are capable of storing information in variousformats and/or encrypted versions. The information may include datarecords associated with various patient information, user preferences, aset of prompts (e.g., question, query, and inquiry), attributesassociated with various pages to be generated by the analytics server110, and the like. The medical records database 120, may have a logicalconstruct of data files, which are stored in non-transitorymachine-readable storage media, such as a hard disk or memory,controlled by software modules of a database program (e.g., structuredquery language (SQL)), and a database management system that executesthe code modules (e.g., SQL scripts) for various data queries andmanagement functions.

The system administrator computer 160 may represent a computing deviceoperated by a system administrator. The system administrator computer160 may communicate with the analytics server 110. The systemadministrator computer 160 may be configured to display various analyticmetrics where the system administrator can monitor gantry movement,patient information, and modify various thresholds/rules describedherein. The system administrator computer 160 may be configurable todisplay certain analytics metrics when specific thresholds/rules havebeen exceeded. For example, the system administrator computer 160 may bealerted if a patient has moved a specified amount during treatment. Theanalytics server 110 may allow the system administrator computer 160 toalso control and/or override the settings of the radiotherapy machine141, the pendant 142, and/or the console monitors 150. For instance, anadministrator may revise the minimum distance threshold and/or customizeany feature on the pages described herein (e.g., move features withinthe page, color, font, shape, size, or the order of display for one ormore pages).

The analytics server 110 may configure the system administrator computer160 to review any and/or all commands made through the radiotherapysystem 140 and/or the console monitors 150 at specified process steps.The system administrator computer 160 may then allow or reject thecommands made through the radiotherapy system 140 and/or the consolemonitors 150. For example, before the technician starts the patienttreatment using the radiotherapy machine 141, the analytics server 110may first prompt the system administrator computer 160 to review theradiotherapy machine 141 parameters for approval. Once approved, thetechnician may then control the radiotherapy machine 141 by the consolemonitor.

The analytics server 110 may configure the system administrator computer160 to review any and/or all reading and/or (over)writing of patientdata to and/or from the medical records database 120. For example,before the technician may (over)write patient information collected bythe radiotherapy machine 141, the analytics server 110 may first promptthe system administrator computer 160 to review the patient informationbefore it is stored in the medical records database 120.

As discussed in greater detail herein, the analytics server 110 maygenerate various pages that are designed to interact with the individualoperating the radiotherapy machine 141, the console monitors 150, and/orthe system administrator computer 160. The analytics server 110 may thengenerate various interactive pages and may instruct the network 130 toincorporate the generated pages displayed on the radiotherapy machine141 and/or the console monitors 150.

The analytics server 110 may generate the various pages for theradiotherapy machine 141, the console monitors 150, and/or the systemadministrator computer 160 synchronously (e.g., simultaneously,contemporaneous). The analytics server 110 may also generate the variouspages for the radiotherapy machine 141, the console monitors 150, and/orthe system administrator computer 160 asynchronously (e.g.,non-simultaneously). The analytics server 110 generates the variouspages by first receiving data from the radiotherapy system 140, themedical records database 120, the console monitors 150, and/or thesystem administrator computer 160. The analytics server 110 analyzes thedata received, and generates the respective page based on the analyzeddata. For example, the analytics server 110 uses the live feed providedby the set of cameras to instruct the console monitors 150 to displaythe live feed and then overlay a page over the live feed to the consolemonitors 150.

In operation, the analytics server 110 may receive a patient identifierfrom a technician operating the pendant 142 connected to theradiotherapy machine 141. The analytics server 110 may then retrievetreatment data from the medical records database 120 and/or the systemadministrator computer 160. Upon analyzing the treatment data, theanalytics server 110 may identify/calculate various treatment attributesassociated with the patient's treatment. Non-limiting examples oftreatment attributes may include alignment angles (e.g., angles in whichthe patient must be positioned to receive optimum treatment),accessories needed, machine parameters, and the like.

The analytics server may then instruct a display screen associated withthe radiotherapy system 140 to display a series of pages on the displayscreen associated with the radiotherapy system 140, such as a displayscreen position on the throat of the gantry. As will be described below,the series of pages may correspond to a workflow-oriented progression oftreatment stages where each page corresponds to a particular stage ofthe patient's treatment and only displays information relevant to thatparticular stage. Using the information provided by the analytics server110, the technician may gather necessary accessories, align the patientin accordance with treatment data, and set up the radiotherapy machine141 accordingly.

After the patient and/or the radiotherapy machine 141 have been properlyset up, the technician may leave the treatment room to allow theradiation treatment to begin. The analytics server 110 may also instructthe console monitors 150 to display a second workflow-oriented series ofpages on the console monitors 150. For instance, the technician or otherauthorized medical professionals (e.g., radiation therapy technicians)may monitor the patient/machine set up before the treatment has begun.The console monitors 150 may also provide patient/machine informationduring the treatment and may allow a medical professional to monitor thepatient's treatment.

Set of Cameras Associated with the Radiotherapy Machine

FIG. 2A illustrates a radiotherapy system 200. The radiotherapy system200 may be similar to the radiotherapy system depicted in FIG. 1A. Theradiotherapy system 200 may include a radiotherapy machine 210. Theradiotherapy machine 210 may be in communication with an analyticsserver 240, such as the analytics server depicted in FIG. 1A, whichcommunicates with the radiotherapy machine 210. For example, theanalytics server 240 may retrieve the patient's RT file from a medicaldatabase. The analytics server 240 may then display various pages on theradiotherapy machine 210, as described herein.

The methods and systems described herein are not limited to theparticular radiotherapy system described and depicted herein (e.g.,radiotherapy system depicted in FIGS. 2A-2G) and may also apply toring-shaped radiotherapy systems, robotic arms, proton radiotherapymachines, FLASH radiotherapy machines, and the like.

The analytics server 240 may also communicate with one or more cameras230 a, 230 b connected or otherwise associated with the radiotherapymachine 210, such as a camera on a couch or walls or ceiling 230 aand/or a camera positioned proximate to a screen on a gantry, or on agantry and not proximate to a screen 230 b. Accordingly, the analyticsserver may use the images captured by the cameras 230 a, 230 b todisplay various information (e.g., alignment of the patient's body,machine parameters, and/or accessories) on one or more pages describedherein.

As described herein, the analytics server 240 may receive treatment dataassociated with a patient from the radiotherapy machine 210. Theanalytics server 240 may use the treatment data in conjunction with datareceived from the set of cameras to display one or more pages describedherein.

FIG. 2A, in conjunction with FIGS. 2B-2F, illustrate various features ofan example radiotherapy machine 210. Even though the display screen 226is depicted as being located on the gantry 224, it is expresslyunderstood that, in alternative embodiments, the display screen 226 maybe located on other parts of the radiotherapy machine or any otherlocation within the treatment room (e.g., on a workstation computerand/or mounted on the wall/ceiling of the treatment room).

The radiotherapy machine 210 may include a couch 222 where the patientis placed to receive radiation therapy treatment. The couch 222 may beconfigured to align the patient in a designated position duringtreatment. For example, the analytics server may retrieve patient datafrom the patient's RT file, analyze the data, and utilize the analyzeddata to position the patient. In some embodiments, a doctor identifieshow to align the patient on the couch 222 to optimize the treatmenttherapy. The couch 222 may be adjusted based on the location at whichthe patient will be receiving therapy. For example, if the patient'stumor is located on their left pectoral, the couch 222 may be thenconfigured so that the radiation targets the patient's left pectoral. Insome embodiments the couch 222 may be adjusted in any axial direction.For example, the couch may be elevated or lowered, it may be adjusted tomove towards or away from the radiotherapy machine 210. The couch 222can also be adjusted for rotation, pitch, and roll around an isocenterpoint. In other embodiments the couch may have fewer degrees offreedom/axes of movement. Segments of the couch 222 may also be adjustedto elevate or lower a segment of the couch 222.

The technician may manually adjust the couch 222 through theradiotherapy system 200. The technician may adjust the positioning ofthe couch 222 using data displayed by the analytics server. Theanalytics server may track the positioning of the couch 222 throughsensors disposed on the radiotherapy machine 210. The analytics servermay automatically adjust the couch 222 when the patient's RT file isselected by the technician. In some configurations, the analytics servermay transmit a notification (to the technician) that adjustment of thecouch may be needed.

The analytics server may also record any changes to the positioning ofthe couch 222 in the patient's RT file and update the medical databaseto include the positioning of the couch 222. For example, after apatient has completed their treatment, the final positioning of thecouch 222 may be recorded by the radiotherapy machine 210. The analyticsserver may then store the final positioning of the couch 222 in thatpatient's RT file. Accordingly, the analytics server will automaticallyadjust the couch 222 to that position for the next treatment of the samepatient. The couch 222 may also be adjusted manually.

The radiotherapy system 200 may further include a pendant. As discussedin greater detail herein, the radiotherapy machine 210 may also becontrolled by a pendant, such as the pendant 142 described in FIG. 1A.The pendant may adjust the positioning of the radiotherapy machine 210through a selection of buttons that axially actuates the radiotherapymachine 210 towards a desired direction. The technician may also use thependant to perform other tasks such as to initialize the radiotherapymachine 210, and/or to have the radiotherapy machine 210 return to itshome position.

The radiotherapy machine 210 may also include a gantry 224. The gantry224 may be disposed on a center axis 225 and is configured to rotateabout the center axis 225. The gantry 224 may be positioned relative toa proximate end of the couch 222. During rotation, the gantry 224 may beconfigured to emit radiation towards the couch 222 while the patient isresting on the couch 222. A non-limiting example of gantry 224 inrotation is depicted in FIG. 2C. In some configurations, the displayscreen 226 is configured to rotate when the gantry 224 is rotating. Therotation of the display screen 226 may be such that the display screen226 maintains its orientation. For instance, the rotation of the gantry224 may be such that it counteracts the rotation of the gantry 224.

The gantry 224 may also include a display screen 226. The display screen226 may be disposed on an external surface of the radiotherapy machine210 adjacent to the proximate end of the couch 224. The display screen226 may further be disposed on a throat of the gantry 224. The displayscreen 226 may be in communication with the analytics server. Theanalytics server may communicate with the display screen 226 to displayvarious pages described herein. For instance, the analytics server mayinstruct the display screen 226 to display a page on the display screen226 that informs the technician of the next step/stage in the treatmentprocess. In various other embodiments, the analytics server deactivatesthe display screen 226 during the radiotherapy to protect the displayscreen 226. For instance, the analytics server may display theworkflow-oriented series of pages described herein allowing thetechnician to set up the patient and prepare the patient for his/hertreatment. When the treatment starts, the analytics server maydeactivate the display screen 226.

The display screen 226 may display a live feed of the patient. Anon-limiting example of this configuration depicted in FIG. 2B. Thedisplay screen 226 may be a touchscreen and may control the pagesgenerated by the analytics server displayed on the display screen 226.In some embodiments, the display screen 226 may be controlled by thependant.

The radiotherapy system 200 may also include an imager 242 that isconfigured to captured medical images, such that medical images of thepatient resting on the couch 222.

The radiotherapy machine 210 may also include a set of cameras 230 a,230 b (collectively 230). The set of cameras may provide a live feed ofvarious perspectives of the radiotherapy machine 210. The set of camerasare in communication with the analytics server. The analytics serverretrieves the various live streams from the set of cameras. Referringnow to FIG. 2C, the analytics server may use the various live streams toanalyze and display the patient's position and alignment data. In someconfigurations, the analytics server may also use the images captured bythe cameras 234, 238 depicted in FIG. 2G to analyze the patient'sposition on the couch in addition to the cameras 230 (not shown in FIG.2G). The analytics server may instruct the display screen 226 to display(e.g., present the page to a processor for displaying) a page onto thedisplay screen 226. The analytics server may provide instructions todisplay various pages on the display screen 226, a console monitor(e.g., a console monitor as depicted in FIG. 1A), and/or a systemadministrator computer (e.g., a system administrator computer asdepicted in FIG. 1A).

The analytics server may utilize the various live streams to control theradiotherapy machine 210. For example, the set of cameras may provide aview of the gantry 224 while in rotation. The analytics server may usethe live feed to measure and monitor the distance between the gantry 224and the patient to avoid a collision. Specifically, the analytics servermay use the images captured by the cameras 234 and/or 238 (depicted inFIG. 2G) and combine that information with a mathematical machine modelto identity the patient's position on the couch 222.

The set of cameras may include a first camera 234. The first camera 234may be positioned at a distal end of the couch 222. The distal end ofthe couch 222 may be diametrically opposed to the proximate end of thecouch 222. The distal end of the couch 222 may also be diametricallyopposed to the display screen 226. The first camera 234 may be disposedon a standalone mount. In various embodiments, the first camera 234 maybe disposed on an axillary component of the radiotherapy machine 210.

As illustrated in FIG. 2E, the first camera 234 may provide a live feedof the couch 222 (e.g., with or without the patient). The first camera234 provides the live feed to the analytics server. The analytics servermay receive the live feed from the first camera 234 and provide it todisplay screen 226. As discussed in greater detail herein, the analyticsserver may overlay pages onto the display screen 226. The analyticsserver may also provide the live feed of one or more cameras discussedherein and the page overlay to the console monitors 150 and/or thesystem administrator 160.

As illustrated in FIG. 2D, the set of cameras may include a secondcamera 236. The second camera 236 may be disposed at the proximate endof the couch 222. The proximate end of the couch 222 may be proximate tothe display screen 226. The second camera 234 may be a 360 degree. A 360degree camera, as used herein, refers to a camera with a spherical fieldof view. In some configurations, the camera 234 may be a 360 camerawhile in other embodiments the camera 236 is a wide-angle camera (180degree camera). The second camera 236 may also provide a live feed ofthe couch 222 (e.g., with or without the patient). The second camera 236provides the live feed to the analytics server. Due to the rotation ofthe gantry 224, the second camera may 236 also rotates. The secondcamera 236 may be configured to counter-rotate with respect to therotation of the gantry 224. For example, if the gantry 224 rotates 20°the second camera rotates −20°. This allows the second camera tomaintain the same orientation during rotation of the gantry 224.

The second camera 236 may not counter rotate, but instead, may rotatethe live feed relative to the rotation of the gantry 224 to maintain theorientation. For example, the second camera 236 may rotate with thegantry so that if the gantry 224 rotates 20° the second camera may alsorotate 20°. In this configuration, the second camera 236 may rotate thelive feed −20° before providing the live feed to the analytics server.Therefore, the camera 236 may utilize software to rotate the transmittedimages instead of (or in conjunction with) physically rotating thecamera itself. The software and the analytical protocols describedherein may be implemented either in the camera (e.g., before theanalytics server receives the feed) or implemented in the analyticsserver (e.g., as part of the image feed post-processing). The displayscreen 226 may be rigidly attached to the gantry. However, in someimplementations, the display screen 226 may feature a physicalcounter-rotation of the screen without necessarily rotating the contentdisplayed on the display screen 226.

In some embodiments, the content of the display screen 226 may alsorotate in a similar fashion as described within the context of thesecond camera 236. For instance, if the gantry 224 rotates 20° in aclockwise orientation, the content of the display screen 226 may alsorotate (e.g., 20° in a counterclockwise orientation). This rotationallows the patient and/or technician to easily view various pagesdescribed herein when the gantry changes its orientation. Moreover, eventhough the display screen is shown as having a rectangular shape, it isexpressly understood that the display screen may be in other shapes(e.g., circular or oval).

In some configurations, the analytics server may manipulate the livefeed (e.g., crop and/or rotate the images received from any of thecameras discussed herein. For instance, the analytics server may rotatethe images received from a camera that it itself rotating, such thatcounter rotation of the camera itself is no longer necessary.

The analytics server may receive the live feed from the second camera236 and provide it to display screen 226. As discussed in greater detailherein, the analytics server may instruct the display screen 226 todisplay various pages onto the display screen 226. The analytics servermay also provide the live feed of the second camera 236 and the pageoverlay to the console monitors 150 and/or the system administrator 160.

The analytics server may display the live feed of the first camera 234and the second camera 236 simultaneously (e.g., at the same time). Theanalytics server may display the live feed of the first camera 234 andthe second camera 236 near-simultaneously (e.g., a delay). The analyticsserver may display the live feed of the first camera 234 and overlaysthe live feed of the second camera 236 at a corner. A non-limitingexample of this configuration is depicted in FIG. 10C. In someembodiments, the analytics server instructs the console monitors 150 todisplay the live feed of the first camera 234 on a first half of theconsole monitors 150 and displays the live feed of the second camera 236at a second half of the console monitors 150.

In some configurations, the analytics server may display the feedreceived from the camera 234 simultaneously with a zoomed crop (e.g.,zoomed portion of the same feed) received from the camera 234 as apicture-in-picture overlay. Therefore, the analytics server may displaytwo feeds (different sizes) from the same camera.

The set of cameras may include a plurality of cameras disposed withinthe treatment room. In some embodiments, the plurality of cameras aredisposed above the radiotherapy machine 210. The plurality of camerasmay provide a top-down view (e.g., bird's eye view) of the radiotherapymachine 210. The plurality of cameras may provide a perspective view(e.g., angled view) of the radiotherapy machine 210. For example, theplurality of cameras may provide a live feed of the rotation of thegantry 224. The plurality of cameras may be positioned to also provide alive feed of the couch 222 (e.g., with or without the patient).

Referring now to FIG. 2G, a non-limiting example of cameras placedwithin the treatment room is illustrated. For instance, the treatmentroom 201 may include a radiotherapy machine (gantry 234 and couch 222)along with the camera 234 described herein. The treatment room 201 mayalso include cameras 238 placed on the ceiling that can monitor variousattributes described herein. For instance, the cameras 238 may bepointed towards the patient where a live feed of the patient istransmitted to the analytics server. As a result, the analytics servermay use various methods described herein (e.g., triangulation frommultiple cameras) to identify the patient's position on the couch or thecouch or the gantry's position itself. The analytics server may adjustthe cameras 238 and point the cameras 238 towards a desired location,for instance by swiveling the cameras 238 at the mounts 239A-B. Inanother configuration (not shown), the cameras 238 can move along tracksin one or more directions. In yet another configuration (not shown), thecameras 238 can swivel and rotate from the posts connected to the mounts239A-B.

The cameras may provide the live feed to the analytics server. Theanalytics server may receive the live feed from the plurality of camerasand provide it to the display screen 226. As discussed in greater detailherein, the analytics server may overlay pages onto the display screen226. The analytics server may also provide the live feed of theplurality of cameras and the page overlay to the console monitors 150and/or the system administrator 160.

In some embodiments one or more of the cameras discussed herein may becapable of determining three dimensional (3D) surface, shape, andpositional information, for example by the use of time of flightcameras, structured light cameras, or any other 3D camera known in theart.

The plurality of cameras may be rearranged at various points within thetreatment room. The plurality of cameras may be disposed on the ceilingof the treatment room or disposed at eye-level. The plurality of camerasmay be disposed to provide a vertical view of the treatment room, ahorizontal view of the treatment room or a perspective view of thetreatment room. In some embodiments, each of the plurality of camerasmay be manually adjusted to provide a desired view of the treatmentroom.

The analytics server may also be configured to execute a triangulationprotocol using the live stream of the plurality of cameras. In someembodiments, each of the plurality of cameras are time-of-flight cameras(e.g., range sensing, distance measuring). In an example, the analyticsserver may execute photogrammetry to extract three-dimensionalmeasurements from the captured two-dimensional subsequent images. Thescale of the subsequent images may be determined, for instance bymeasuring various distance of the patient (e.g., length of arms, lengthof legs, and the like) and associating the measured distances of thegantry and/or couch with an image of patient (e.g., the subsequentimages), the analytics server may determine the current position of thepatient using the distances measured and the subsequent images.

Additionally, or alternatively, the analytics server may usetriangulation to generate a three-dimensional model of the patient basedon images from various perspectives (e.g., the set of cameras in thetreatment room). As an example, the analytics server may associate atwo-dimensional pixel in the subsequent images with a ray inthree-dimensional space. Given multiple perspectives of the image (e.g.,at least two sets of subsequent images capturing the position of thepatient from at least two different perspectives), a three-dimensionalpoint can be obtained as the intersection of at least two rays frompixels of the subsequent images.

The analytics server may execute various consistency functions todetermine that the rays from the subsequent images are associated withconsistent pixels. For instance, the analytics server may determine fromthe consistency functions, whether the pixels used to determine thethree-dimensional point are similar colors and whether the pixels usedto determine the three-dimensional point are similar textures.

The analytics server may compare the subsequent images or generatedthree-dimensional model to the reference image and/or model. Forexample, the analytics server may determine a position vector based onthe comparison of the subsequent image or generated three-dimensionalmodel and the reference image and/or model, indicating the difference inposition of the gantry, couch, and/or patient in the subsequent image orgenerated three-dimensional model to the compared reference image and/ormodel.

The analytics server may measure the distance of the patient relative tothe motion path of the gantry 224 or other machine parts (e.g., theimagers attached to the radiotherapy machine). The analytics server maythen monitor patient movement during treatment. The patient may bemonitored such that the patient adjustments exceeding a threshold may berevealed (and an operator may be informed of the movement), while theanalytics server may determine that patient adjusts within a thresholdmay be a result of patient breathing. If the patient at any point may bewithin proximity of the movement path of the gantry 224, the analyticsserver may then send a call to the radiotherapy machine 210 toimmediately stop rotating the gantry 224 and/or the beam delivery. Theanalytics server may also be configured to provide a prompt to theconsole monitors 150 and the system administrator 160 of the potentialcollision between the radiotherapy machine 210 and the patient. Theanalytics server may then resume rotation of the gantry 224 after userintervention. For instance, a clinician or a medical professional mayrealign the patient, such that the patient is no longer at risk ofcolliding with the radiotherapy machine. Upon the realignment, thetreatment may continue. For instance, the radiotherapy treatmenttechnician may continue with the workflow described herein.

The analytics server may also be configured to provide the consolemonitors 150 and the system administrator 160 a warning prompt if thepatient may be within a specified margin of the motion path of thegantry 224. The analytics server may reduce the velocity of the gantry224 when the patient may be within the specified margin of the motionpath of the gantry 224 or other parts of the radiation therapy machine.

The analytics server may assign a position to any item that may bewithin the radial path of the gantry 224. For example, if the patient isconnected to a ventilator during treatment, the analytics server mayassign a position to the ventilator through the live feed of theplurality of cameras. The analytics server may then monitor the positionof the ventilator during treatment.

Pendant Configuration

FIGS. 3A-3B illustrate various components of a pendant 300. The pendant300 may be similar to the pendant depicted in FIG. 1A. The pendant 300may be communicatively coupled to a radiotherapy machine, such that thependant can transmit instructions to the radiotherapy machine. Theradiotherapy machine may be similar to the radiotherapy machine depictedin FIG. 1A. The pendant 300 may be connected to the radiotherapy machinethrough wireless communications according to, for example, Bluetoothspecification sets or another standard or proprietary wirelesscommunication protocol. In various embodiments, the pendant 300 may beconnected to the radiotherapy machine through a wired connection 302 orbe integrated into the radiotherapy machine. The pendant 300 may also bein communication with a computer and/or server (e.g., such as theanalytics server depicted in FIG. 1A).

The pendant 300 may be used to navigate the workflow-oriented series ofpages described herein. Additionally, or alternatively, the variouspages associated may be standalone pages that can be separatelydisplayed (e.g., not as a part of the workflow-oriented series ofpages). The workflow-oriented series of pages may be modified (e.g.,with respect to content, with respect to order, with respect to thenumber of stages) by the pendant 300. Therefore, the pendant 300 canalso navigate (can be used to navigate each page individually).

The pendant 300 may also be used to adjust the positioning of theradiotherapy machine through a selection of buttons that position theradiotherapy machine (axially or otherwise) in a desired direction. Atechnician may use the pendant 300 to initialize the radiotherapymachine 141, to have the radiotherapy machine 141 return to its homeposition. The radiotherapy machine may include a couch (e.g., such asthe couch depicted in FIG. 1A). The couch may be configured to align thepatient in a designated position during treatment. The pendant 300 maybe configured to position the couch. The designated position may beidentified by the analytics server or calculated by the technician (orany other medical professional). In some embodiments, a doctoridentifies how to align the patient on the couch to optimize thetreatment therapy. The technician may use the pendant 300 to move thecouch and align the patient to receive optimum radiotherapy treatment.

The pendant 300 may include a processor in communication with aradiotherapy machine 340, a console monitor (e.g., such as the consolemonitor depicted in FIG. 1A) and/or a system administrator computer(e.g., such as the system administrator computer depicted in FIG. 1A).The processor may include a computer-readable medium 310 a, such as arandom access memory coupled to the processor (310). The pendant 300 maybe executing algorithms or computer executable program instructions,which may be executed by a single processor or multiple processors in adistributed configuration. The pendant 300 may be configured to interactwith one or more software modules of a same or a different typeoperating within the pendant 300. Non-limiting examples of the processormay include a microprocessor, an application specific integratedcircuit, and a field programmable object array, among others. Thependant 300 may be capable of executing data processing tasks, dataanalysis tasks, and valuation tasks.

The pendant 300 may include a first controller 312 configured to adjustat least one configuration of the radiotherapy machine 340. Inparticular, the first controller that may adjust the positioning of thecouch (312). The first controller that may include a button or aplurality of buttons (e.g., switches, toggle, and/or knob) disposed onthe pendant 300. As depicted in FIG. 3B, the plurality of buttons mayinclude a rotating wheel 318. The pendant 300 may also include aseparate rotating controller (not shown here) for each rotationalaccess. For instance, the clinician may use this rotating controller totoggle among axes (e.g., toggle to control different axes).

The rotating wheel 318 may facilitate movements of the couch or otherrotational motions. In some embodiments, the rotating wheel 318facilitates fine-tune movement of the couch. The plurality of buttonsmay also include a set of buttons 320 configured to position the couchtowards specific axial directions. The set of buttons 320 may bedisposed at an end of the pendant 300. In some embodiments, the set ofbuttons 320 are disposed in the center of the pendant 300. The set ofbuttons 320 may include a first group of buttons 322 configured tofacilitate the axial movement of the couch in the X-axis and Y-axis. TheX-axis and Y-axis may be on the same plane as the resting surface of thecouch.

Various features described in the pendant 300 may be customized based ondifferent user's preferences. For instance, a medical professional maycustomize the functionality of one or more features (e.g., buttons,touch pad, or any other feature of the pendant 300) such that saidfeature can adjust the radiotherapy machine accordingly. In someconfigurations, the medical professional may use the wheel 318 todetermine which attribute of the radiotherapy machine to adjust. Forinstance, the medical professional may use the wheel 318 such that thebuttons 322 only adjust the couch, collimator, or the gantry. Therefore,the wheel 318 may be used as a toggle and reconfigured the functionalityof other buttons described herein. The wheel 318 may be spring-loaded toavoid accidental actuation by the medical professional.

The set of buttons 320 may also include a second group of buttons 324configured to facilitate the axial movement of the couch in the Z-axis.The Z-axis may be orthogonal to both the X-axis and the Y-axis.

The plurality of buttons may also include a safety button 328. Thesafety button 328 may need to be depressed (or otherwise interactedwith) before repositioning the couch. The pendant 300 may be configured,such that interactions with the safety button 328 may be required forany external machine motion. The safety button 328 may prevent theaccidental repositioning of the couch if the set of buttons 320 areunintentionally pressed by a user. The safety button 328 may be disposedon the side of the pendant 300. In some embodiments, the safety button328 may be disposed on the front or back of the pendant 300. The safetybutton 328 may also be embedded in the individual axis controls and mayuse separate circuitry as the rest of the features described herein. Insome embodiments, the safety button 328 may be disposed on an auxiliarycomponent. For instance, the safety button 328 may be actuated orde-actuated to interrupt the motion should one of the controls fail(e.g., when a feature of the pendant 300 is stuck in the engagedposition). Various alternative features of the safety mechanismdescribed above are also described in U.S. patent application Ser. No.15/957,727, which is incorporated by reference herein in its entirety.

It may be desirable for the pendant 300 to have a control separate fromthe radiotherapy machine controller (first controller 312) to avoidaccidental commands on the radiotherapy machine controller that areintended to control the GUI. In this embodiment, the pendant 300includes a second controller 330. The second controller 330 may beconfigured to receive an input from a user to be received by a computer(e.g., such as the analytics server depicted in FIG. 1A). The computerrevises a page displayed on a gantry 342 of the radiotherapy machine340. The second controller 330 may include a touch pad 332 (e.g.,touch-sensitive). The touch pad 332 may utilize capacitive sensing orresistive sensing. The touch pad 332 may be disposed at the center ofthe pendant 300. In some embodiments, the touch pad 332 may be disposedon an end of the pendant. The touch pad 332 may be configured to allow auser to register movements through touch. For example, the user canswipe from the center of the touch pad 332 to a first side of thependant 300. The computer may then revise the page to provide additionalpatient information.

Different movements performed on the touch pad 332 may result indifferent input types used to navigate and/or otherwise interact withthe pages described herein. For example, if the user swipes the touchpad 332 in a first direction, it may cause the workflow to continue tothe next step. If the user swipes the touch pad 332 in an oppositedirection, it may cause the workflow to return to the last step. Thesemovements (and the corresponding action performed by the analyticsserver) may be customized by the users. For instance, a user can set upthe system, such that a circular motion on the touch pad causes theanalytics server to move backwards or forward within theworkflow-oriented series of pages.

The touch pad 332 may also be configured to register several points ofcontact, which would generate additional input types. For example, ifthe user uses two figures to swipe the touch pad 332, the touch pad 332may be configured to hide a page. In another example, if the user uses asingle figure to swipe the touch pad 332, the touch pad 332 may beconfigured to alternate between different pages.

The touch pad 332 may be clickable (e.g., depressible) so that itprovides an additional input type. For example, if the user clicks thetouch pad 332, the workflow may register that as an input that thecurrent step has been completed. In some configurations, functionalityassociated with the touch pad 332 may be performed using other inputelements, such as buttons, wheels, and the like. For instance, insteadof interacting with the touch pad 332 to navigate through the GUIsdescribed herein, the user may interact with physical buttons (e.g.,next, previous). Therefore functionality attributed to the touch pad 332is not limited to touch pad technology.

The second controller 330 may also include a return button 334 (e.g.,back button). The return button 334 may also be used to register aninput for the pages. The return button 334 may be disposed adjacent tothe touch pad 332. The return button 334 may cause the workflow toreturn back a step. For example, if the technician would like to returnto a prior step of the workflow, the technician may press the returnbutton 334.

The second controller 330 may also include a “home” button 336. “Home,”as used herein, may refer to a machine home/unload position. Therefore,interacting with the home button 336 may cause the workflow to go to anunload step.

The pendant may also include an “enter” button. The enter button mayalso be used to register an input for the pages. The enter button may bedisposed adjacent to the touch pad 332. The enter button may be used tonavigate the workflow. The enter button may navigate the workflow to goto a home page. The home page may be the first page of the workflow. Forexample, if the technician would like to return to a first page, thetechnician may press the enter button. In some embodiments, the homepage may be the first page of the stage of the workflow the user iscurrently in.

The pendant 300 may be a handheld device that may be operated by thetechnician, e.g. while preparing the patient and/or the radiotherapymachine, or while unloading the patient after radiotherapy treatment. Insome configurations, the pendant 300 may be connected to theradiotherapy machine (using a wire or wirelessly) where the pendant 300can be freely moved by the technician. In some configurations, thependant 300 may be mounted to the radiotherapy machine, such that thependant's movements are restricted. For instance, the pendant 300 can bemounted (removably or irremovably) to the couch, gantry, display screen,or any other part of the radiotherapy machine.

The pendant 300 may be designed to be operated by the technician's foot.For instance, the pendant 300 may be placed/mounted on the couch suchthat the technician can interact with pages described herein using thetechnician's foot. For instance, the size and shape of various buttons,rotating wheel 318, touch pad 332 or other features may be revisedaccordingly.

In some configurations, the pendant 300 may include a lighting featurewhere one or more of the input elements described herein (rotating wheel318, touch pad 332, return button 334, home button 336, safety button328, and/or buttons 320) can be highlighted for easier access. In someconfigurations, the lighting feature may emit white light. However, thecolor and intensity of the light may be customized by the technicianand/or the system administrator. In some configurations, color/intensitycould also be used to communicate different states of the controls orguide the user through the workflow described herein.

In some configurations, various input elements described herein may bedepressed/recessed (e.g., flushed with the surface of the pendant) toavoid accidental actuation by the technician.

The pendant 300 may also include a “back” button. The back button mayallow the user to navigate one step back in the workflow. For instance,the user may interact with the back button to navigate to a previouspage or stage. The back button may also be customized to navigate theuser to the main screen from any of the secondary screens. Additionally,the pendant 300 may include a “menu button” that may provide additionaloptions to the user. Therefore, the menu button may behave similar tothe common use of the right mouse click in current desktop or laptopcomputers, such that its function is context sensitive e.g. brings upthe position presets when used in the machine parameter screen but showssecondary screen navigation on the main screen. Even though the backbutton and the menu buttons are described in the context of “buttons,” askilled artisan will recognize that “button” refers to any input elementimplemented on the pendant 300.

Treatment Room GUI:

FIG. 4A illustrates a flowchart depicting operational steps performed bythe analytics server in accordance with an embodiment. The method 400 adescribes how a server, such as the analytics server described in FIG.1A, displays various interactive pages configured to display variousstages of performing radiotherapy on a patient (e.g., a person to betreated by the radiotherapy machine). Even though the method 400 a isdescribed as being executed by the analytics server, the method 400 acan be executed by any server(s) and/or performed locally using acomputer/processor associated with the radiotherapy machine and/or theconsole (as discussed in FIGS. 10A-10D). Other configurations of themethod 400 a may comprise additional or alternative steps, or may omitand/or mix one or more steps altogether.

At step 402, the analytics server retrieves an RT file associated withone or more patients. The RT file may be retrieved from one or moremedical databases (such as the medical database in FIG. 1A), servers,files, and the like.

The RT file may comprise a patient identifier. The patient identifiermay be a series of numbers and/or letters to identify patients. A user(e.g., technician, doctor, nurse, or other professional) and/or systemadministrator may determine the patient identifiers and map the patientidentifiers with particular patients. The analytics server may updatethe RT file such that the RT file contains the mapped patientidentifiers and associated patients. Additionally, or alternatively, theanalytics server may store the mapped patient identifiers and associatedpatients.

The RT file may further include various treatment details associatedwith the patient's treatment. For instance, the RT file may includevarious couch/gantry attributes, such as couch angles, gantry rotationattributes (e.g., full or partial arcs), the number of partial arcs (ifapplicable), machine trajectories, control points, and the likeassociated with each patient. In an example, the treatment data (e.g.,RT file) may include the amount of dose delivered to the patient at eachdetermined control point of the planned machine position.

In addition, the RT file may contain patient information, includingpersonal identifying information (PII) such as the diagnoses of thepatients, the name of the patient, nicknames of the patient, thebirthdate of the patient, one or more photos of the patient, and thelike. The RT file may also contain notes from one or more doctorsregarding the patient and/or the diagnoses of the patient, and medicaldiagnoses tools such as x-ray scans, including computed tomography (CT)scans, MRI images, SPECT images, PET images, ultrasound images, and thelike. The RT file may also include whether the treatment is a volumetricmodulated arc therapy (VMAT) treatment, intensity-modulated radiationtherapy (IMIRT) treatment, or high dose rate (FLASH) treatment.

Additionally, or alternatively, the RT file may contain a list ofpatients (or patient identifiers) and a corresponding time associatedwith each patient. In some embodiments, the corresponding time mayindicate the time at which the patient is expected to arrive at thetreatment room for a treatment appointment. In other embodiments, thecorresponding time may indicate the time at which the patient isexpected to begin an appointment with the radiotherapy machine. In otherembodiments, the corresponding time may indicate the time at which thepatient is expected to arrive at the treatment center (e.g., a clinic,hospital).

The RT file may also contain various patient attributes. Patientattributes may include the height of the patient, the length of thepatient's arms, the length of the patient's legs, the width of thepatient's torso and other bodily measurements. The analytics server maydetermine the measurements of the patient's body based on one or morecameras or other devices feeding the analytics server images and/or livevideo data. Additionally, or alternatively, a user may input patientmeasurements such that the analytics server receives measurements of thepatient's body. The analytics server may also retrieve measurements ofthe patient's body from the RT file or other one or more servers, filesand/or databases.

Additionally, or alternatively, the analytics server may retrieveinformation contained within the RT file from one or more source. Forinstance, the patient identifier may be retrieved by the analyticsserver from a medical database (such as the medical database in FIG.1A), the treatment details associated with the patient's treatment maybe retrieved from a doctor's file. Additionally, or alternatively, theanalytics server may retrieve various portions of information fromvarious source. For instance, patient identifiers and treatment detailsassociated with the patient's treatment may be retrieved by theanalytics server from a medical database (such as the medical databasein FIG. 1A). Further, some PII may be retrieved by the analytics serverfrom a patient file, while other PII may be retrieved by the analyticsserver from a library.

At step 404, the analytics server presents, in response to receiving aselection of a patient from the one or more patients in the RT file, apage associated with the selected patient. The response by the servermay be generated by a user input (e.g., an input from a pendant asdiscussed in FIGS. 3A-3B, an input from a console as discussed in FIGS.10A-10D), an input from the screen displayed on the radiotherapymachine, and the like. Additionally, or alternatively, the response bythe server may be in response to a timing trigger (e.g., the time atwhich the patient is expected to begin an appointment with theradiotherapy machine).

Steps 402 or 404 describe an embodiment where the analytics serverretrieves RT files associated with multiple patients and then receives aselection from an operator of the radiotherapy machine (e.g., technicianin the treatment room) for a particular patient. Upon receiving theselection, the analytics server identifies treatment data (RT file(s))associated with the selected patient and displays the GUIs describedherein. Therefore, the method 400 is specific to the patient who isbeing treated.

The analytics server presents the GUI on a display of a screenassociated with the radiotherapy machine (e.g., the screen positioned onthe gantry as described in FIGS. 2A-2F) or alternatively, on a screenlocated elsewhere within the treatment room. The screen may be placedonto (other otherwise connected to) the radiotherapy machine itself,such as by placing the screen on the throat (or any other part) of thegantry. The screen may also be placed communicatively coupled to theradiotherapy machine and positioned in the treatment room (e.g., thesame room as the radiotherapy machine). Various other screens maydisplay the GUIs presenting information from the analytics server. Forinstance, screens in rooms outside of the treatment room (such as aconsole screen in a room monitoring the treatment room) may also displaythe GUIs presenting information from the analytics server. Additionally,or alternatively, the GUI may be displayed on various platforms. Forinstance, a user may view the GUIs displayed by the analytics server onthe various platforms by executing an application such as a browserapplication.

Various pages of the GUI associated with the method 400 may be a part ofa workflow-oriented series of pages described herein. Additionally, oralternatively, the various pages associated with the method 400 may bestandalone pages that can be separately displayed as a GUI (e.g., not asa part of the workflow-oriented series of pages). The workflow-orientedseries of pages of the GUI associated with the method 400 can bemodified (e.g., with respect to content, with respect to order, withrespect to the number of stages) by a system administrator and/or user.

The GUI(s) described herein may be displayed on multiple screens (and onvarious platforms) in a synchronous or asynchronous manner. Forinstance, the analytics server may display the GUI(s) on the throat ofthe gantry, radiotherapy room screen, console monitors, and/or aphysician device in a simultaneous or near simultaneous manner, suchthat one or more users can monitor the actions of the user in thetreatment room. Additionally, or alternatively, the analytics server mayreceive one or more inputs that may raise an alert and/or indicator onthe GUI displayed to the user in the treatment room. The alert and/orindicator may be visual and/or audible. For instance, a user in adifferent room (e.g., console room) may notify the user in the treatmentroom that the user in the treatment room is missing something and/or didnot complete a task. The analytics server may also receive one or moreinputs that cause a change in the displayed page of the GUI in thetreatment room (or the console room). For instance, the displayed pagemay change to display a different page.

The analytics server may display an image of the radiotherapy machine(e.g., couch) on the GUI. As described in FIGS. 2A-2F, the analyticsserver may be in communication with one or more cameras (e.g., camera onthe couch, gantry camera, or other cameras places within theradiotherapy room). Additionally, or alternatively, the analytics servermay present for display a live feed of the radiotherapy machine (e.g.,live feed of the couch with or without the patient) on the GUI.

The analytics server instructs the screen associated with theradiotherapy machine (e.g., positioned on the gantry of the radiotherapymachine) to present pages of the GUI on the screen in step 404 where thepages correspond to stages of a treatment workflow using theradiotherapy machine (e.g., stages of treatment shown in FIG. 4B). Theworkflow described herein may be preconfigured, such that it cannot berevised by different unauthorized parties However, in someconfigurations, a user and/or system administrator may determine thenumber of stages and the content associated with each of the stages. Insome embodiments the analytics server may present each of the sevenpredetermined stages on one or more pages of the GUI, in addition tosupplemental pages with supplemental information. One or more pages maybe used to describe the workflow stages to treat a patient using aradiotherapy machine. The workflow on the GUI (presented by theanalytics server) describes the work performed by a user to treat apatient using the radiotherapy machine.

The analytics server displays only relevant information on the GUIduring each stage. Relevant information, as used herein, may refer toinformation that facilitates a user advancing to the next stage.Relevant information, as used herein, may refer to a subset of allinformation used to treat the patient at a given stage in the workflow.The relevant information is consumed by the user while the user performstasks at a given stage of workflow. The analytics server displays therelevant information for the current stage of workflow on a page. A userand/or system administrator may determine what is considered relevantinformation. Further, the user and/or system administrator may determinewhether information is relevant for various stages of the workflow. Theanalytics server may not display information that is not relevant, whichmay include information that a user will have to remember for succeedingstages in the workflow or information that is not pertinent tocompleting the particular stage because it involves a future stage or analready-completed stage. The relevant information may be visuallyorganized in different areas of the displayed page using various typesof graphical elements, as described below.

The GUI may display various graphical indicators. A graphical indicator,as used herein, may correspond to any graphical component (e.g.,graphical icon) displayed on a page. Non-limiting examples of agraphical indicator may include icons in different shapes (e.g.,rectangular, square, and circle) and/or in different colors (e.g.,black, white, red, orange, or translucent), and the graphical indicatormay optionally include text (any alphanumeric characters). Graphicalindicators may be used to represent information, such as adjustments tobe made to the configuration of the radiotherapy machine, aligning apatient with a predetermined angle, accessories for treatment, and thelike. Example pages having graphical indicators include pages 400 c-400p shown in FIGS. 4C-4P (as well as FIGS. 11C-N).

On some of the pages, the analytics server may display a progressindicator. The progress indicator may be comprised of various graphicalindicators and/or text (or some combination). The progress indicatordisplayed on the pages indicates a progression of the stages (e.g.,highlighting the workflow step). In some embodiments, namescorresponding to each of the stages may be displayed on the progressindicator. In other embodiments, numbers corresponding to each of thestages may be displayed on the progress indicator. Example pages havinggraphical indicators may include pages 400 c-400 p shown in FIGS. 4C-4P(as well as FIGS. 11C-N).

In some configurations, the GUI may emphasize the name of the stage onthe process indicator. In an example, the GUI may emphasize the name ofthe currently displayed stage by highlighting the currently displayedstage name (e.g., using a color such as white, red, or yellow). The GUImay display the preceding and succeeding stages using contrasting colorsas such as grey, black, or translucent. In another example, the GUI mayemphasize the name of the current displayed stage by using shapes. Forinstance, the name of the currently displayed stage on the page maycorrespond (partially or fully) by a shape. The GUI may display thepreceding and succeeding stages using shapes that are different from theshape containing the name of the currently displayed stage. For example,the current stage name may be contained within a circle, while thepreceding and succeeding stages may be in a square.

Additionally, or alternatively, the name of the stage currentlydisplaying on the page may be bordered in a way that is visibly distinctfrom the border for the preceding and succeeding stages. For instance,the name of the currently displaying stage may be enclosed in a dashedshape, while the preceding and succeeding stages may be enclosed in asolid shape. Further, the current stage name may be enclosed in aborder, while the preceding and succeeding stages may not be enclosed ina border.

In some configurations, all of the stages of workflow may be displayedon the progress indicator (e.g., using numbers or text or the like) ofthe GUI. Additionally, or alternatively, a portion of all of the stagesmay be displayed on the GUI. Additionally, or alternatively, theanalytics server may display only the current stage of the workflow onthe GUI. Additionally, or alternatively, the analytics server may onlydisplay on the GUI the stages of the workflow that have been completed(in addition to the current stage of the workflow). Additionally, oralternatively, the analytics server may only display on the GUI thestages of the workflow that have not been completed (in addition to thecurrent stage of the workflow). The stage indicated on the progressindicator on the GUI allow the system administrator and/or user to moreeasily determine the current stage.

The GUI may display the progress indicator anywhere on the pageincluding horizontally along the bottom of the page, horizontally alongthe top of the page, horizontally along a side of the page (e.g., as ifin a column a side of the page), vertically along a side of the page(e.g., rotated vertically along a side of the page), in the middle ofthe page, some position offset from the middle of the page, and thelike. A system administrator and/or user may determine the position ofthe progress indicator on the page.

On some of the pages, the analytics server may display treatment relatedimages. The treatment related image may be an image taken by a doctor,technician, or a user related to treatment. For example, treatmentrelated images might convey positions the patient should lie in foroptimal treatment, positions of accessories with respect to the patientand/or radiotherapy machine, x-rays, CT scans, ultrasounds and the like.In some instances, the treatment related image might be atwo-dimensional or three-dimensional representation (e.g., animationand/or four-dimensional CT scan imaging). Pages including treatmentrelated images may include pages 400 c-400 p shown in FIGS. 4C-4P (aswell as FIGS. 11D-M).

The GUI may display the treatment related image anywhere on the pageincluding horizontally along the bottom of the page, horizontally alongthe top of the page, horizontally along a side of the page, verticallyalong a side of the page (e.g., treatment related image is rotatedvertically), across the whole page (e.g., a background), in the middleof the page, some position offset from the middle of the page, and thelike.

On some of the pages, the analytics server may display one or morenon-treatment related images. The non-treatment related images may beelected by the patient based on the patient's preferences. In othercircumstances, the non-treatment related image might be selected by aperson other than the patient (e.g., the non-treatment related imagemight be a logo of the clinic in which the treatment is occurring).Pages including non-treatment related images may include pages 400 c-400p shown in FIGS. 4C, 4K, and 4P.

The GUI may display the non-treatment-related image anywhere on the pageincluding horizontally along the bottom of the page, horizontally alongthe top of the page, horizontally along a side of the page, verticallyalong a side of the page (e.g., non-treatment related image is rotatedvertically), across the whole page (e.g., a background), in the middleof the page, some position offset from the middle of the page, and thelike.

Some of the pages may display a background. The GUI can display for thebackground a solid color, a pattern, a treatment related image, anon-treatment related image, and the like. Additionally, oralternatively, the background may be a live view of the couch using athree-dimensional representation (e.g., animation) of the couch.Additionally, or alternatively, the GUI may display a live feed view ofthe couch (including the user and/or patient captured by a camera livefeed) based on a received live stream of data from one or more cameras.As discussed herein, the cameras placed on the gantry, at an end of thecouch, on the ceiling, or generally within the room comprising theradiotherapy machine (e.g., as discussed in FIGS. 2A-2F). Further, thebackground of the page may be in focus (clear) or out of focus (blurry).Pages including a background may include pages 400 c-400 p shown inFIGS. 4C-4P.

The GUI may display a live feed of the radiotherapy machine, forinstance, a live feed of the couch based on a received live stream ofdata from the one or more cameras on the radiotherapy machine and/or inthe treatment room. The displayed live feed of the radiotherapy machinemay be an actual image (revised in real time or near real time as thepatient enters into view of the camera or as the radiotherapy machinesmoves) and/or a two-dimensional or three-dimensional representation(e.g., animation) representing the radiotherapy machine. Pages includingthe live feed of the radiotherapy machine may include pages 400 c-400 pin FIGS. 4C-4P.

Non-limiting examples of camera placements that provide the analyticsserver the live feed of the radiotherapy machine include cameras placedon the gantry, on the couch, on the ceiling, or generally within theroom comprising the radiotherapy machine (e.g., as discussed in FIGS.2A-2F). In the event the patient enters into a view of a camera, theanalytics server may display a live feed of the patient and theradiotherapy machine (e.g., a live feed of the patient positioned on thecouch). The displayed live feed of the patient (or portion of thepatient) may be an actual image (revised in real time or near real timeas the patient enters moves on the couch) and/or a two-dimensional orthree-dimensional representation (e.g., animation) representing thepatient.

The analytics server may continuously receive the live feed of theradiotherapy machine from the cameras (or other devices capable ofcapturing images in real time or near real time). The analytics servermay continuously analyze the live feed of the radiotherapy machineaccording to the methods described herein, even in the event that theanalytics server does not display the live feed of the patient and/orradiotherapy machine. In the event that the analytics server is notdisplaying the live feed of the radiotherapy machine, the analyticsserver may be triggered to display the live feed of the radiotherapymachine. The analytics server may be triggered to display the live feedof the radiotherapy machine in the event that the analytics serverreceives an input from a user to display the live feed of theradiotherapy machine. For instance, the user in the treatment room mayprovide an input to the analytics server using a pendant and/orinteracting with the screen on the gantry. Additionally, oralternatively, a user in a different room (who may be viewing the samepage or other screen corresponding to the same stage on a differentscreen) may provide an input to the analytics server to display the livefeed of the radiotherapy machine. Additionally, or alternatively, theanalytics server may present the live screen, for instance, in the eventa certain amount of time has elapsed or a problem is detected oranticipated.

The GUI may display notes. In some embodiments, the GUI displays notesbased on a received stream of data from a console (e.g., as discussed inFIGS. 10A-10D). The console may be used to update the analytics serverand provide information to the analytics server in real time. Inaddition, the analytics server may be used to update the console andprovide information to the console in real time. In other embodiments,the analytics server displays notes that have been previously stored bythe analytics server (e.g., setup notes, notes of patient preferences,notes of accessory placement). The notes may also include contentretrieved from any of the data sources described in FIG. 1A, such astreatment notes inputted by a treating oncologist.

The GUI may display the display notes anywhere on the page includinghorizontally along the bottom of the page, horizontally along the top ofthe page, horizontally along a side of the page (e.g., the analyticsserver displays the display notes on the page such that the displaynotes appear below/above each other as if in a column on a side of thepage), vertically along a side of the page (e.g., display notes arerotated vertically), in the middle of the page, some position offsetfrom the middle of the page, and the like.

The analytics server may display a graphical indicator corresponding toone or more accessories. The identification of the accessories necessaryfor the patient treatment is described herein (e.g., FIGS. 7A-7C). Thegraphical indicator corresponding to one or more accessories may bedisplayed by the analytics server in conjunction with a status indicatorto convey/identify whether the analytics server has identified necessarypredetermined accessories to be present within a predeterminedproximity. For example, the status of the accessories may be provided invarious ways including a color scheme where different colors representdifferent statuses. For instance, a red graphical indicator represents amissing or incorrect accessory, an orange graphical indicator representsthe placement of the accessory must be fixed before treatment begins,and a grey graphical indicator represents the accessory is present andin a proper location. A graphical indicator may also be shown aspartially orange, whereby the extent of the orange portion represents anamount of adjustment, alignment, or other action needed. Likewise, agraphical indicator may be shown as partially grey, whereby the extentof the grey portion represents an amount that is already in asatisfactory position, stage, or completion.

The status of the accessory may be provided using different shapesrepresenting different statuses. For instance, an octagon associatedwith an accessory represents a missing or incorrect accessory, arectangle associated with an accessory represents the placement of theaccessory must be fixed before treatment begins, and a circle associatedwith an accessory represents that the accessory is present and in aproper location. Additionally, or alternatively, the status of theaccessory may be provided using different borders representing differentstatuses. For instance, a solid border around a shape represents amissing or incorrect accessory, a dashed border around a shaperepresents the placement of the accessory must be fixed before treatmentbegins, and no border represents that the accessory is present and in aproper location. The statuses used in the status indicator makes thevarious statuses visually distinct. These status indicator statuses suchas the color, shape, and border can be revised based on user preferencesand/or system administrator. The analytics server may display statusindicators in conjunction with other graphical indicators.

The GUI may display the accessory graphical indicator anywhere on thepage including horizontally along the bottom of the page, horizontallyalong the top of the page, horizontally along a side of the page (e.g.,the analytics server displays the accessories on the page such that theaccessories appear below/above each other as if in a column on a side ofthe page), vertically along a side of the page (e.g., the accessoriesare rotated vertically), in the middle of the page, some position offsetfrom the middle of the page, and the like.

As depicted, the accessory indicators may be placed on the left side ofthe GUIs described herein to indicate the left side pullout panelcontains more information related to the accessories. As a result, theuser may indicate a desire to view more information by interacting withthe GUIs depicted in FIGS. 7B-C. For instance, the user may click leftand the analytics server may display more detailed information regardingthe accessories. The same principle may be applied to the patient infodisplayed within the top portion of many of the GUIs described hereinand/or the machine info depicted on the right side. While the locationof these panels could be an arbitrary decision that is revisable by theend users, the proximity of the indicator to these panels is deliberateand consistent with the way the analytics server displays theinformation. Therefore, the placement of the indicators corresponds tothe workflow.

The analytics server may also indicate the status of the workflow stageusing ambient light. The analytics server may also indicate a status ofthe machine, e.g., a collision detected, fault/error, progress of thetreatment, etc., or even reflect the patient's mood or biologicalfunctions relevant to the treatment, such as the patient's breathing.

The analytics server may control the color of ambient light in thetreatment room, ambient light originating from under the couch, ambientlight originating from one or more portions of the radiotherapy machine(e.g., a bezel on the machine), and the like. The ambient light may becontrolled by the server to convey information. In some instances, theambient light may convey binary information to the user (e.g., theworkflow stage is complete or the workflow stage is incomplete). Forexample, while the user is performing the tasks on the page related to aparticular stage of workflow, the ambient light may be orange. When theuser finishes a predetermined number of tasks (e.g., all of the tasks)related to the displayed stage on the page, the analytics server maychange the ambient light to blue, indicating that the workflow stage hasbeen completed.

The analytics server presents a GUI on the screen associated with theradiotherapy machine (e.g., positioned on the gantry) in step 404 forthe selected patient from the one or more patients. The GUI transitionsfrom a first page to a second page based on an input received by theserver, as shown in step 406.

The second page may contain information corresponding to a stage on thefirst page. For example, the second page may contain additionalinformation about the stage on the first page. For instance, during theRoom Setup stage (e.g., Stage Two), as discussed herein, the server maydisplay, on a first page of the page, a live feed of the patient on thecouch. The analytics server may use graphical indicators on the firstpage to provide information about certain tasks. For instance, agraphical indicator coupled with a status indicator may provide someinformation as to the accessories that the analytics server isdetecting. A user may use the pendant and switch the displayed page fromthe live feed of the patient on the couch having accessory informationprovided in the form of graphical indicators and/or status indicators toa second page containing information that describes the accessoriesrequirements in more detail.

Additionally, or alternatively, the second page may not contain at leastsome information belonging to the stage on the first page. In anon-limiting example, the first page may display information related toa particular stage of the workflow and the second page may containinformation related to the subsequent stage of the workflow. In thiscircumstance, the second page is used to display informationfacilitating the user's progression through the stages of the workflow,not to provide more information about the first page.

A user using a pendant may generate an input to the analytics serverusing a pendant, as discussed herein (e.g., FIGS. 3A-3B). The user mayactivate, press, touch, spin, swipe, actuate, or otherwise interact withthe pendant to generate the input for the analytics server.

Additionally, or alternatively, the input received by the analyticsserver may be a flag or other notification signaling the completion ofparticular one or more tasks (or the completion of a predeterminedportion of tasks) displayed on the GUI. A user and/or systemadministrator may determine the predetermined portion of tasks thattrigger the flag or other notification signaling the completion of theparticular one or more tasks. For instance, a user may be viewing a pageand adjust the patient and/or perform the steps as recommended on thepage. In the event the analytics server determines that a task has beenperformed, the analytics server may generate the flag or othernotification. The analytics server may use a flag threshold to determinewhether a predetermined portion of tasks has been performed. Forexample, if the flag threshold is two, but only one flag has beengenerated (representing that only one task has been completed), then theanalytics server can determine that a predetermined portion of taskshave not been completed. In some embodiments, when the analytics serverdetermines that the predetermined portion of tasks has been completed(e.g., the flags generated by the analytics server meets and/or exceedsthe flag threshold), the analytics server may display an interactivebutton (e.g., a graphical indicator configured to receive an input). Toprogress from the current stage of the workflow to a subsequent stage ofthe workflow, the user may need to interact with the interactive button,indicating that the user is ready to progress. For example, theinteractive button may have an indicator (such as an arrow to the nextstage) or text (e.g., “next,” “continue,” “proceed,” “done”)

In a non-limiting example, the analytics server receives a live feed ofthe couch from a camera placed on the gantry (or other position such asthe cluster of cameras placed within the ceiling and/or walls of thetreatment room). The analytics server continuously/periodically scansthe live feed to identify information related to the information beingdisplayed on the page. For example, the analytics server may displaygraphical indicators corresponding to required and/or detectedaccessories on the Patient Alignment page (e.g., Stage Four, asindicated by FIGS. 4L-4M). Further, the analytics server may displaygraphical indicators corresponding to amounts and/or directions ofadjustments to be performed by the technician/clinician on the patient(e.g., making sure the patient's arms are in the right place such thatthe exposure of the radiation to non-intended parts of the body islimited). Based on the information on the page, the accessories andadjustments to the patient's body may be made before the radiotherapytreatment begins.

As discussed with respect to FIGS. 7A-7C, the analytics server may useradio-frequency identification (RFID) technology, in addition to othertechnology, to identify the locations of one or more accessories withina predetermined proximity to the radiotherapy machine. In addition, oralternatively, the system may use any known identification technology toidentify locations of one or more accessories within a predeterminedproximity to the radiotherapy machine, such as but not limited to QRtags, image reconstruction, segmentation, trained AI/machine learningalgorithms, bar codes, Bluetooth, Bluetooth low energy, etc. Theanalytics server may be in communication with one or more nearby RFIDreaders, which can in turn communicate with one or more RFID tags placedonto each accessory devices. In a non-limiting example, the analyticsserver queries/activates an RFID reader placed on the couch. As aresult, the RFID reader communicates with all RFID tags within the RFIDreader's range and transmits RFID tag numbers/identifiers to theanalytics server. The analytics server then queries a data table toidentify an accessory associated with each received RFID number toidentify the corresponding accessory.

The proximity, as used herein may indicate an amount of distance awayfrom the radiotherapy machine or an exact location on the couch, in theroom, or any other predetermined location (e.g., indicated by the userand/or a system administrator).

The analytics server may have a threshold that determines how many flagsmust be obtained before moving to the next stage. In one embodiment, theanalytics server may require only a subset of the flags to progress tothe next stage. However, the analytics server could alternativelyrequire all flags before moving to the next stage. For example, in theevent that the flag threshold to progress to the next stage is twoflags, then the singular flag would not be enough to progress the stageto any subsequent stages. Subsequently, the GUI would continuedisplaying the current stage until the user addresses the other task onthe page (e.g., adjusting the patient for a satisfactory position fortreatment).

In some embodiments, the analytics server may continueperiodically/continuously query the RFID reader to determine whether theaccessories (or predetermined number of accessories) are still withinthe predetermined proximity to the radiotherapy machine. In the eventthe accessories are moved out of the predetermined proximity, theanalytics server may remove the raised flag or other indicatorassociated with the completion of the accessory task.

The analytics server may track the movement of the patient using anysuitable tracking mechanism and determine, based on the trackedmovement, that the patient's position is satisfactory for treatment. Forinstance, the analytics server may use time of flight generated pointcloud or structured light technology to obtain object information. Inother examples, the analytics server may use Simple Online Real-TimeTracking (SORT) technology to track the patient's movement. Morespecifically, the analytics server may perform object detection todetermine what an object is and where the object is within a frame oflive data. A frame can be considered a window of live video data for afixed duration of time. In a non-limiting example, object detection maybe performed by the analytics server dividing the frame into regions andcreating boundary boxes around the objects within each region.

In some instances, the analytics server may apply boundary boxes toobjects using a computer model (e.g., an object recognition neuralnetwork trained to detect objects). In some instances, the analyticsserver may apply classification approaches to determine the boundaryboxes by utilizing Support Vector Machines, K-means clustering, and thelike. Each boundary box around the object may have an associated classand a probability of that boundary box belonging to the class (e.g.,whether the object in the frame corresponds to trained classes ofobjects such as a portion of the couch, a portion of the accessory, or aportion of the patient). The objects in each of the boundary boxes inthe regions comprise a total object. For instance, a finger may beclassified in one boundary box of a region, where the finger isassociated with the patient's finger because the finger belongs to theclass of the patient.

The analytics server propagates the detected object from the currentframe to a subsequent frame. Specifically, the analytics server mayapply the Kalman Filter to estimate the next position of the boundaryboxes and/or object based on the boundary box and/or object estimatedvelocity and position within the current frame. The analytics server maycompare the estimated positions of the boundary box and/or object to theactual location of the boundary box and/or object in the latest frame.The estimated prediction of the boundary box and/or object can beoptimized using, for instance, the intersection over union metric tomeasure the accuracy of estimated boundary box and/or object. Theintersection over union metric considers the area of overlap between theestimated boundary box and/or object and actual boundary box and/orobject and the area of union of the estimated boundary box and/or objectand actual boundary box and/or object.

The objects may be labeled with identifiers. Identifiers can be used todistinguish between the objects and/or classes. For example, a patientmay be labeled with a certain identifier to distinguish the patient fromthe user. Similarly, the user may be labeled with a certain identifier.In an example, the analytics server may determine to create anidentifier to be tracked in the event that the predicted area of overlap(with respect to the estimated boundary box and/or object and actualboundary box and/or object) is less than a predetermined acceptableintersection over union metric. In some cases, the identifiers of theobject correspond with the class.

The analytics server may determine that the patient is in a satisfactoryposition for treatment by comparing a position of patient in a framefrom the live stream of data to frames in a stored acceptable positionof a patient. The analytics server may determine that the position ofthe patient from the live stream of data is acceptable when the positionof the patient is within a predetermined margin of error from a storedsatisfactory position for treatment. When the analytics serverdetermines that the patient is in an acceptable position (or within thepredetermined acceptable margin of error), the server may raise a flag(and/or receive a flag as an input) or other notification of theacceptable position.

The server may continuously monitor the patient to track any furthermovement because the patient may move into an unsatisfactory position(e.g., out of the acceptable margin of error) over time. In the eventthe patient moves to an unsatisfactory position, (or exceeds one or morethresholds that take into the patient breathing) if the analytics serveris still displaying the Patient Alignment stage (as shown in FIGS.4L-4M), the flag that was raised that indicated the patient's acceptableposition will be removed and the patient will have to get into anacceptable position again. The analytics server may display an alertsuch that the user is notified that the patient is not in an acceptableposition for treatment. Such flagging may also be used to stop thetreatment delivery or even be used to guide an auto-correction of thepatient position.

The analytics server may communicate with one or more cameras to capturethe position of the patient. In some instances, the captured position ofthe patient may be two-dimensional (e.g., an image) or three-dimensional(e.g., a model). In some instances, the captured image of the patient ina satisfactory position for treatment may be converted into athree-dimensional model. In other instances, the server may retrieve athree-dimensional model, three-dimensional image, or two-dimensionalimage stored in memory of the analytics server, from a database, orcontained within the RT file. The analytics server may label and/oridentify the captured position of the patient in the satisfactoryposition for treatment according to an identifier (e.g., a referencesatisfactory position image and/or model). The reference satisfactoryposition image and/or model may be used as a reference image and/ormodel.

The analytics server may communicate with one or more cameras to capturesubsequent images of the position of the patient. The captured positionof the patient may be received by the analytics server as a series oftwo-dimensional continuous timeframes (e.g., subsequent images). In anexample, the analytics server may execute photogrammetry to extractthree-dimensional measurements from the captured two-dimensionalsubsequent images. The scale of the subsequent images may be determined,for instance by measuring various distance of the patient (e.g., lengthof arms, length of legs, length of a limb, position of a joint such as aknee or elbow) and associating the measured distances of the gantryand/or couch with an image of patient (e.g., the subsequent images), theanalytics server may determine the current position of the patient usingthe distances measured and the subsequent images.

Additionally, or alternatively, the analytics server may usetriangulation to generate a three-dimensional model of the patient basedon images from various perspectives (e.g., the one or more cameras inthe treatment room). As an example, the analytics server may associate atwo-dimensional pixel in the subsequent images with a ray inthree-dimensional space. Given multiple perspectives of the image (e.g.,at least two set of subsequent images capture the position of thepatient from at least two different perspectives), a three-dimensionalpoint can be obtained as the intersection of at least two rays frompixels of the subsequent images.

The analytics server may determine that the rays from the subsequentimages are associated with consistent pixels. For instance, a pixel froma first perspective of an image, mapped to a three-dimensional pointusing a ray based on the first perspective of the image, is consistentwith a pixel from a second perspective of an image mapped to the samethree-dimensional point using a ray from the second perspective of theimage. The analytics server may determine from the consistencyfunctions, whether the pixels used to determine the three-dimensionalpoint are similar colors, whether the pixels used to determine thethree-dimensional point are similar textures the textures, and the like.

The analytics server may compare the subsequent images or generatedthree-dimensional model to the reference image and/or model. Forexample, the analytics server may determine a position vector based onthe comparison of the subsequent image or generated three-dimensionalmodel and the reference image and/or model, indicating the difference inposition of the gantry, couch, and/or patient in the subsequent image orgenerated three-dimensional model to the compared reference image and/ormodel.

The analytics server may present on the GUI the content associated withthe position vector to the user and/or patient. For example, the GUI maypresent a numerical and/or graphical representation of the magnitude anddirection of the position vector. For example, the direction of theposition vector may indicate the adjustments that the patient should bemoved using directions such as up, down, left, right to return thepatient to the satisfactory position for treatment. The magnitude of theposition vector may indicate the extent of the difference between thesubsequent images or generated three-dimensional model and the comparedreference image and/or model to return the patient to the satisfactoryposition for treatment. In another example, the analytics server maydisplay graphical indicators to convey the direction (e.g., arrowsrepresented by the graphical indicators). Additionally, oralternatively, the analytics server may display the extent of differencebetween the subsequent image captured and the compared reference imageusing colors. For instance the color red may indicate a differencegreater than 10 mm, the color orange may indicate a difference betweenthe subsequent image and reference image from 5-10 mm, and the colorgrey may indicate a difference between the subsequent image andreference image from 0-5 mm. The colors and associated differencesbetween the subsequent image and reference image may be determined by auser and/or system administrator.

The analytics server might employ the described methods herein todetermine satisfactory positions for treatment of the couch and/organtry. However, the analytics server's monitoring of the patient'sposition when loaded onto the couch is not limited to the methods andsystems described herein. The analytics server may use other imagerecognition protocols to identify whether the patient's position isconsistent with the alignment data indicated by the reference surfaceand/or image (e.g., is the patient aligned with the predetermined anglesoptimizing the patient's position to receive radiation treatment).

In the event that the analytics server receives an input generated bythe user, the analytics server may determine whether one or more flagsrepresenting one or more completed tasks satisfy a flag threshold. Ifthe analytics server determines that the predetermined portion of taskshave been completed (e.g., the flags generated by the analytics serverexceeds and/or meets the flag threshold), then the analytics server maytransition the displayed first page associated with information relatedto a particular stage of the workflow to a second page containinginformation related to the subsequent stage of the workflow. If theanalytics server determines that the predetermined portion of tasks havenot been completed (e.g., the flags generated by the analytics serverdoes not exceed and/or meet the flag threshold), then the analyticsserver may conditionally transition the displayed first page associatedwith information related to a particular stage of the workflow to asecond page containing information related to the subsequent stage ofthe workflow.

The analytics server may conditionally transition such that preceding orsucceeding pages may be displayed, but the analytics server may refrainfrom registering any tasks on the preceding or succeeding pages. Forinstance, the tasks completed on the second page may not be registeredby the analytics server until the tasks on the first page are completed.

Additionally, or alternatively, in the event the analytics serverreceives an input to transition the second page to a third page, theanalytics server will conditionally transition to the third stage. Forinstance, the analytics server displays the content associated with thethird page but does not register the completion of any tasks associatedwith the third page. In some circumstances, the third page is related tothe second page (e.g., a page that provides more details about thesecond page). In other circumstances, the third page is associated witha third stage of the workflow (e.g., the user is able to view theworkflow tasks associated with the third page displayed by the analyticsserver).

The analytics server may display a graphical indicator and/or textindicating that the pages displayed have been conditionallytransitioned. For instance, the graphical indicator may indicate thatthe user is viewing the pages in a “view only” mode, thereby limitingthe tasks recognized by the analytics server. For example, a graphicalindicator may appear on a page informing that the user that any tasksperformed by the user in response to the displayed tasks on the page maynot be registered by the analytics server. The analytics server may alsodisplay the conditionally transitioned pages such that the pages appearvisibly distinct. For example, the page that the server hasconditionally transitioned to may appear faded with less contrast,brightness, or color.

Additionally, or alternatively, if the analytics server determines thatthe predetermined portion of tasks have not been completed (e.g., theflags generated by the analytics server does not exceed and/or meet theflag threshold), then the analytics server may deny the user fromtransitioning to a subsequent page associated with a next stage in theworkflow. Additionally, or alternatively, the analytics server maydetermine not to transition from the first page (showing the first page)to the second page (showing the second page) based on an input receivedfrom an additional user and/or third party (including a systemadministrator or supervisor). For instance, a user and/or third partyviewing the page displayed by the analytics server may effectively“pause” a user in the treatment room from progressing to a subsequentpage associated with a next stage in the workflow. The “pause” of theworkflow may be for a predetermined period of time or until theanalytics server receives additional one or more inputs from the sameuser and/or third party (or a different user and/or third party). The“pause” of the workflow for the predetermined period of time may bedetermined by a user and/or system administrator. The user, systemadministrator, supervisor or the like may “un-pause” the “paused”workflow progression (even in the event the “pause” of the workflow isfor a predetermined period of time) by inputting one or more inputs tothe analytics server.

Additionally, or alternatively, the analytics server may transition to asecond page associated with the next stage in the workflow even if theanalytics server has determined that the predetermined portion of taskshave not been completed (e.g., by comparing the one or more receivedflags generated upon the completion of the one or more tasks to the flagthreshold). In the event the analytics server transitions to the secondpage associated with the next stage in the workflow even though theanalytics server has determined that the predetermined portion of taskshave not been completed, the analytics server may display an indicationthat the predetermined portion of tasks from the first page have notbeen completed. The indication may be visually distinguishable from thecontent on the page. For instance, the indication may have contrastingcolors from the content, different shapes than those used in thecontent, different borders than those used in the content, contrastingshine or translucence from the content, contrasting texture from thecontent, contrasting pattern from the content, and the like.

In one embodiment, another user or GUI (e.g., GUI displayed on aconsole) can receive an input to halt progress on another GUI (e.g., GUIdisplayed in a treatment room). In response to receiving an inputgenerated by the user in the treatment room, a user outside of thetreatment room, a system administrator or other third party, theanalytics server displays an alert on the GUI that one or more taskshave not been completed on the first page. For instance, the GUIsdisplaying different stages of the workflow for the console monitorscannot progress to the next stage until one or tasks within thetreatment room are completed.

FIG. 4B illustrates seven stages of workflow to be performed in atreatment room for a successful execution of treating a patient withradiation using a radiotherapy machine, in accordance to an embodiment.Although seven stages are shown, it is intended that the workflow cancomprise any number of stages and/or sub-stages. The method 400 bdescribes the workflow stages of performing radiotherapy on a patientdisplayed on a GUI by a server, such as the analytics server describedin FIG. 1A. The workflow stages displayed by the analytics server aredisplayed on various interactive workflow-oriented series of pagesconfigured to display the various stages. Even though the method 400 bis described as being executed by the analytics server, the method 400 bcan be executed by any server(s) and/or performed locally using acomputer/processor associated with the radiotherapy machine and/or theconsole. Other configurations of the method 400 b may compriseadditional or alternative stages, or may omit and/or mix one or morestages altogether. Further, each of the seven stages of workflowrepresented in method 400 b may be standalone stages displayed by theanalytics server on standalone pages.

In describing the various stages of workflow, references is also made toFIGS. 4C-4P, non-limiting examples of the analytics server displayingpages of a GUI based on a user's progression through the stages of theworkflow. Even though FIGS. 4C-4P illustrate a progression in sequentialpages, in some configurations the analytics server may display thedepicted pages in another order. Moreover, the analytics server may notdisplay one or more of the pages described herein. The analytics servermay display various combinations and configurations of the pagesdepicted herein. In particular, the pages depicted in FIGS. 4C-4Pillustrate one or more pages displayed by the analytics server through adisplay on a gantry, as described in FIG. 1A. The analytics server mayuse the methods and systems described herein to displayworkflow-oriented series of pages (e.g., page 400 c-400 p in FIGS. 4C-4Prespectively) such that a user progresses through the workflow tosuccessfully treat a patient using a radiotherapy machine.

At step 410, the analytics server displays a page on a GUI representingStage One. In this example, Stage One relates to patient selection. Auser using a patient identifier (e.g., name, social security number,other identifier) selects a patient for treatment using the display onthe radiotherapy machine. In other embodiments, the analytics server mayautomatically select a patient according to a schedule. For instance,the analytics server may store the schedule of patients and theassociated patient identifiers (or other patient name) for the day,week, month, and the like. The analytics server may retrieve treatmentdata associated with the selected patient based on the patientidentifier from a database, the RT file, the analytics server's memory,and the like.

As will be described below, the console monitors will also provide theusers the option to select the patient. However, in some embodiments,when a patient is selected in the treatment room, the analytics serversyncs the information displayed on the console monitors, such that theyare consistent and correspond to the same patient, or visa-versa.

The analytics server and/or the RT file may associate treatmentinformation with the selected patient. For example, the treatmentinformation associated with the patient may include variouspatient-preferred and/or treatment-necessitated couch/gantry attributes,such as couch angles, gantry rotation attributes (e.g., full or partialarcs), the number of partial arcs (if applicable), personallyidentifiable patient information (e.g., name, nickname, birthdate,photos), diagnoses of the patients, notes from one or more doctorsregarding the patient and/or the diagnoses of the patient, and medicaldiagnoses tools (e.g., x-ray scans, including computed tomography (“CT”)scans, MM, PET, SPECT, or ultrasound images).

As depicted in FIG. 4C, the analytics server may display a page on ascreen, the page indicating information associated with Stage One of theworkflow. The analytics server may display Stage One of the workflow onthe page before a patient arrives at the treatment room and/or clinic.

The page 400 c (Stage One, Patient Selection) displayed in FIG. 4Cillustrates an initial page displayed by the analytics server on ascreen. The analytics server may display text 420C indicating thepatients scheduled to be treated using a particular radiotherapymachine. The schedule of patients to be treated using a particularradiotherapy machine displayed by the analytics server may include thepatient's name associated with a time. In some instances, the time maybe the time the patient is expected to arrive at the clinic (or othertreatment area). In other instances, the time may be the time thepatient is expected to begin treatment (e.g., the patient enters atreatment room). In some instances, the time may be the time the patientis expected to check-in at a waiting area (e.g., the user may beginprepping a treatment room). In some instances, the analytics server maydisplay a wait time, or the time that has elapsed since the patient haschecked in. The patient's name may be the patient's full name (or aportion of the full name, such as a last name) and/or a nickname.

The analytics server displays text 413C, conveying (and in someinstances emphasizing) the patient scheduled for upcoming treatment. Thetext 413C may emphasize the patient scheduled for upcoming treatment byindicating the patient schedule for upcoming treatment with a colordifferent from the colors (if any) from the patient scheduled to betreated using the particular radiotherapy machine. In othercircumstances, the emphasis of the patient scheduled for upcomingtreatment may be indicated by containing the patient scheduled forupcoming treatment within a shape (e.g., within a rectangle or circle orthe like). The shape may be a different shape than shapes containingeach of the other patients scheduled to be treated using the particularradiotherapy machine. In an example, the shape may indicate that thepatient is present (e.g., in the waiting room).

Additionally, or alternatively, the patients scheduled to be treatedusing the particular radiotherapy machine may not be contained in anyshape. In other circumstances, the emphasis of the patient scheduled forupcoming treatment may be indicated by bordering the patient scheduledfor upcoming treatment within a particular border (e.g., a dashed line).The patients scheduled to be treated using the particular radiotherapymachine may be indicated by a border different than the border used toindicate the patient scheduled for upcoming treatment (e.g., no border,a solid border).

The analytics server may display PII using text and/or graphicalindicators. The analytics server may display the image 415C depicting animage of the patient scheduled for upcoming treatment. The image of thepatient may be used by the user to identify the patient as the patiententers the treatment room. The analytics server may display text 411Cindicating an identity of the patient. In some circumstances, theidentity of the patient may be patient's name may be the patient's fullname (or a portion of the full name, such as a last name) and/or anickname. Additionally, or alternatively, the analytics server maydisplay 403C indicating a patient identifier. The patient identifier maybe used to identify a patient stored in the memory of the analyticsserver and/or contained within RT file. The patient identifier may alsoinclude date of birth, age, gender, or any other PII.

The analytics server may display text 422C indicating the current time.In some circumstances, a digital or analog clock may be displayed by theanalytics server to represent the time. The analytics server may display423C displayed by the analytics server indicates the current date andday of the week. In some circumstances, a calendar (e.g., month view,week view) may be displayed by the analytics server to represent thedate and/or day of the week. The analytics server may displaynon-treatment related image 429C. The non-treatment related image 429Cmay be any image that is used to create a more astatically pleasing GUI,identify the treatment center, etc. The analytics server may displaytext 425C indicating one or more areas of the patient requiringtreatment.

The analytics server may also display the graphical indicator 424Cindicating to the user that a motion management strategy should beemployed for the patient in order to mitigate or compensate for thepatient's minor movements resulting from the patient's breathing. Suchmotion mitigation strategies may include, but are not limited to,gating, tracking, breath-hold, deep inspiration breath hold, coachedbreath hold, etc. The graphical indicator 424C may indicate which motionmanagement strategy is to be employed for the current patient. As willbe described below, the analytics server may use the methods and systemsdescribed herein to align the patient's target organs (e.g., the organreceiving radiation) with various predetermined angles, such that thetreatment is optimized. Moreover, as described herein, the analyticsserver may align the patient's body using various alignment data.However, the patient's minor movements due to breathing may impede thealignment efforts. Thus a motion management strategy may be required orprescribed.

The analytics server may use various methods to determine whether thepatient is causing relevant movement. For instance, the analytics servermay use one or more of the cameras described herein to monitor thepatient's body (e.g., stomach or chest) to detect movements caused bythe patient breathing. The analytics server may display the graphicalindicator 424C to inform the user that the analytics server isminimizing or eliminating the effect of the breathing motion on thealignment treated area. For instance, when an analytics server does notemploy at least one of the above-described motion management strategies,the analytics server or the operator may be more sensitive to thepatient's alignment.

The analytics server may display graphical indicator 427D representing asafety feature associated with the treatment room. Safety featuresassociated with the treatment room can include closing the door of thetreatment room before the treatment is commenced, locking the positionof the couch in the treatment room, hanging the pendant in the treatmentroom, and the like. Various graphical indicators (not shown) may bedisplayed representing safety features associated with the treatmentroom.

The graphical indicator 427C and/or 427D represent a safety feature thatmay be displayed by the analytics server in conjunction with a statusindicator to convey what the analytics server has identified as thestatus of the safety feature. For instance, one safety feature may bethe door to the treatment room. The graphical indicator representing thedoor to the treatment room in conjunction with a status indicator may beused to convey to a user that the door is open, closed, locked, and thelike. The status indicator may be used to convey the status of thegraphical indicator as discussed herein (e.g., with colors, shapes,borders).

In other embodiments, the graphical indicator 427D displayed by theanalytics server may represent more than one safety feature associatedwith the treatment room. For example, graphical indicator 427D mayrepresent that a treatment room has more than one safety feature (e.g.,a lock to the treatment room, a lock for couch, a lock for variouscabinets in the treatment room, an alert ensuring that the pendant is ina proper position). The status indicator may convey what the analyticsserver has identified as the status of the one or more safety features.In some instances, the status indicator may convey a binarydetermination. For example, the status indicator may convey that each ofthe one or more safety features indicated by graphical indicator 427Dare proper or not proper.

The analytics server may display graphical indicator 428C representingmachine alignment parameters (e.g., gantry, couch, and/or collimatorparameters). The machine alignment parameters may be used, for instance,by a user to evaluate whether the gantry of the machine is aligned. Forexample, the analytics server may display graphical indicator 428Cdisplaying a machine alignment parameter that indicates the gantry is ata zero position. The user may determine, based on the gantry positiondisplayed via graphical indicator 428C, that the gantry is properlyaligned.

Additionally, and/or alternatively, the analytics server displayspatient and/or treatment information on a page. The treatmentinformation may include the number of treatments left and a list of thepatient's upcoming appointments (e.g., treatment appointments, doctorappointments). The displayed patient information may include PIIincluding, but not limited to, the diagnoses of the patients, the nameof the patient, the nickname of the patient, the birthdate of thepatient, and one or more photos of the patient. Further, the analyticsserver may display one or more non-treatment related images. In somecircumstances, the non-treatment related images may be selected by thepatient based on the patient's preferences. In other circumstances, thenon-treatment related image might be selected by a person other than thepatient (e.g., the non-treatment related image might be a logo of thecenter in which the treatment is occurring).

At step 412, the analytics server displays a page on a GUI representingStage Two. In this example, Stage Two relates to setting up the roombased on the selected patient from step 410. In some circumstances, theroom is set up before the patient arrives at the treatment room, theclinic where the treatment is being performed, and/or a waiting room. Inother circumstances, the room is set up while the patient is in thetreatment room, the clinic where the treatment is being performed,and/or a waiting room.

Setting up the room according to step 412 includes at least setting upthe accessories and verifying machine parameters. The analytics servermay display a graphical indicator (and a status indicator in conjunctionwith the graphical indicator) to inform the user whether the accessoriesrequired for the patient's treatment are within a predeterminedproximity to the radiotherapy machine (or a specific location). Asdiscussed in FIGS. 7A-7C, RFID or other technology may be implemented toidentify the location of one or more accessories. The analytics servermay also simplify displaying the location of the one or more accessoriesby merely indicating the status of the accessories. For instance, statusindicators may be used to represent that the accessory is missing, theaccessory is in an incorrect position, or that the accessory is presentand placed properly. Further, the analytics server may display machineparameters. The machine parameters may be used by a user to verify thatthe machine is positioned correctly (e.g., that the gantry is at a zeroposition or the machine is aligned with the positions specified in theRT file). Additionally, or alternatively, the analytics server maydisplay information relating to an initial couch position (e.g., aposition of the couch that facilitates the user laying (or sitting) onthe couch.

In some instances, if a user interacts with a pendant (as discussed asdescribed in FIGS. 3A-3B), the analytics server proceeds to Stage Two ofthe workflow (e.g., Room Setup) in FIG. 4 (the page 400 d). In otherinstances, a third party (e.g., a different technician, nurse, doctor)or the user (e.g., walking from the treatment room to a console) mayinteract with the console (as described in FIGS. 10A-10D) to indicate tothe analytics server to proceed to Stage Two of the workflow (e.g., RoomSetup) in FIG. 4 (the page 400 d). Further, in other instances, theanalytics server may proceed to Stage Two of the workflow (e.g., RoomSetup) shown in FIG. 4D (the page 400 d) based on a scheduledappointment time (determined by the analytics server, for instance,using the RT file).

As described throughout, the GUIs described as being displayed on theconsole monitors and the GUIs described as being displayed within thetreatment room may be in-sync, such that accessing patient information(e.g., opening a patient file) in the treatment room ensures that datadisplayed on the console monitor is updated accordingly, and vice versa.This method also prevents opening of different (and sometimesincompatible) files at different locations.

The background 433D of the page 400 d is a view of the couch. Theanalytics server may display a live view of the couch using athree-dimensional representation (e.g., animation) of the couch.Additionally, or alternatively, the analytics server may display a livefeed view of the couch based on a received live stream of data from theone or more cameras. As discussed herein, the cameras may be placed onthe gantry, at an end of the couch, on the ceiling, or generally withinthe room comprising the radiotherapy machine (e.g., FIGS. 2A-2F).

The page 400 d includes a progress indicator 434D. As described herein,the progress indicator displayed on the page 400 d indicates aprogression of the stages. The progress indicator 434D may be displayedon the bottom of the page 400 d horizontally. The analytics serverindicates the current stage of the workflow 4341D (e.g., Stage Two, RoomSetup). The current stage of the workflow is emphasized, for example, bythe analytics server because the server displays the current stage ofthe workflow 4341D in a different color (e.g., white) from the otherstages of the workflow (e.g., grey). The stages that have been completed4342D, for example, are displayed in grey by the analytics server, inaddition to stages preceding the current stage 4340D.

Display notes 436D displayed by the analytics server describes setupnotes associated with the patient scheduled for treatment. The setupnotes in the display notes 436D may be a portion of the setup notes (ora summary of setup notes). The setup notes may describe patientpreferences, doctor comments, notes from prior treatment sessions, andthe like. In the event the user needs more information about the setupnotes, the user may navigate to an additional page of the Room Setupstage to consume additional information about room setup (e.g., FIGS.4E-4G).

The analytics server may use graphical indicator 430D (including 430D1,430D2) to display accessories necessary for patient treatment (e.g., asdescribed in FIGS. 7A-7C). The analytics server displays the graphicalindicators 430D representing the accessories (and the status of theaccessories) on the side of the page 400 d such that the accessoriesappear in a column. The analytics server may determine the accessoriesnecessary for the patient according to the RT file or other one or moreservers, databases, and/or files. Additionally, the analytics server mayuse status indicators in conjunction with the graphical indicator 430D.The status indicators in conjunction with graphical indicator 430Dindicate the accessories necessary for treatment and convey whether theanalytics server has located the accessory.

The analytics server may determine the location of the accessory usingtechnology such as RFID technology (e.g., as described in FIGS. 7A-7C),or any other suitable technology as described above. A red statusindicator shown in conjunction with the accessory indicated by thegraphical indicator 430D2 may indicate that the wrong accessory iswithin a predetermined proximity from the couch. Additionally, oralternatively, an orange status indicator shown in conjunction with theaccessory indicated by the graphical indicator 430D may indicate thatBolus 1 and Bolus 2 may be in an incorrect placement.

When using RFID technology, the analytics server may only detect whetherthe identified accessory is within a predetermined area (e.g., whetherthe accessory is present within the field of reception). Therefore, eventhough the exact location of the accessory may not be identified, theanalytics server may determine whether the accessory is present.

The analytics server may display text 425D that describes identifyingpatient information. The identifying patient information may be derivedfrom the RT file and/or memory of the analytics server. The identifyingpatient information may include PII, as discussed herein. For example,text 403C describes the patient's birthday. Text 411C describes thefirst and last name of the patient. Further, text 424D describes thepatient identifier associated with the patient. The server may use thetext 423D, 422D, and 424D alone or in combination to identify thepatient. In other circumstances, other text identifying the patient maybe displayed by the analytics server.

The graphical indicator 432D describes the areas of the patientrequiring treatment. As shown, one patient may have multiple areas ofthe body requiring treatment. In the event that multiple areas of thebody require treatment, the treatments may be performed consecutively.In such circumstances, one area of the body will be treated first, andupon treatment completion, the stages of the workflow may restart (orpartially restart) such that the stages of the workflow are performedagain with respect to the next area of the body to be treated. Forexample, the accessories required for one area of the body requiringtreatment may be different from the accessories required for a differentarea of the body requiring treatment. The graphical indicator 432Ddescribes the treatment areas with graphical indicator 409D describingthe current area of the body being treated and graphical indicator 408Ddescribes the next area of the body needing treatment. As shown, theanalytics server is describing the Room Setup (Stage Two of theworkflow) for the treatment of the right lung.

In some embodiments, the analytics server may display the sameinterlocks and machine alignment parameters on the Stage Two of theworkflow as was displayed by the analytics server on Stage One of theworkflow (e.g., graphical indicator 427C and 428C respectively). Thegraphical indicator displaying the interlocks by graphical indicator427D may be beneficially displayed to the user, for instance, toindicate that the treatment room is closed. The graphical indicatordisplaying the machine alignment parameters by graphical indicator 428Dmay be beneficially displayed to the user, for instance, to indicate thealignment of the gantry. For example, the user may collide with thegantry as the user is carrying accessories so it may help the user todisplay machine alignment parameters such that the user can move thecouch accordingly.

In some instances, the user may seek additional information related tothe information on the page displayed by the analytics server. Theanalytics server may provide further information to the user in responseto receiving various inputs. The user may interact with the screen onthe radiotherapy machine (e.g., the display may be a touchscreendisplay). Additionally, or alternatively, the user may interact with thependant (e.g., the pendant described in FIGS. 3A-3C). An example of thetypes additional information that the analytics server may provide basedon the user input is displayed in example 400 e of FIG. 4E.

The user may input the response 440E that indicates to the analyticsserver that the user is seeking additional setup information details.For instance, the user may swipe left on the display, press a leftbutton on the pendant, swipe left on the trackpad of the pendant, or thelike. In the event that the analytics server receives the response 440E,the analytics server may display page 400 f or 400 g associated withFIGS. 4F and 4G respectively.

The user may indicate to the analytics server that the user is seekingto perform an action. For instance, the user may perform an action(e.g., press a “back” button on the pendant, press a middle button onthe pendant, press the trackpad on the pendant, press the middle of thedisplay) to indicate to the analytics server that the user is seekinginformation on a workflow related stage (e.g., previous workflow stages,future workflow stages). Additionally, or alternatively, in the eventthe user has performed the tasks on the workflow related pages (e.g.,pages that have workflow related tasks as opposed to pages that simplydisplay additional user information) the user may input response 442E toadvance the workflow. As shown, the user interacts with an interactive“Action” button to input response 442E.

The user may input the response 446E that indicates to the analyticsserver that the user is seeking additional patient information details.For instance, the user may swipe up on the display, press an up buttonon the pendant, swipe up on the trackpad of the pendant, or the like. Inthe event that the analytics server receives the response 446E, theanalytics server may display page 400 h associated with FIG. 4H.

The user may input the response 444E that indicates to the analyticsserver that the user is seeking additional machine details. Forinstance, the user may swipe right on the display, press a right buttonon the pendant, swipe right on the trackpad of the pendant, or the like.In the event that the analytics server receives the response 444E, theanalytics server may display page 400 i associated with FIG. 4I.

Additionally, or alternatively, the analytics server may display example400 e as a page on the screen on the radiotherapy machine in response toa user input (e.g., a “menu” button on the pendant and/or display). Insuch cases, the analytics server displays to the user the interactions(e.g., inputs 440E-446E) that the user must perform to consumeadditional information.

Referring now to FIGS. 4F and 4G, the analytics server may displayadditional setup information based on an input 440E as shown in FIG. 4E.For instance, pages 400 f and 400 g may be considered as examples ofsecond pages of Stage Two (Room Setup). The setup information on page400 f may not be mandatory within the series of pages. That is, the usermay never view page 400 f and the analytics server may not display page400 f unless and until required by the user (e.g., by an input). Forinstance, because page 400 f may not be mandatory, in some radiotherapytreatment sessions, the user may seek the additional setup informationsuch that the analytics server will display page 400 f. In otherradiotherapy treatment sessions, the user may not seek the additionalsetup information such that the analytics server will not display page400 f. In contrast, during every radiotherapy treatment sessions usingthe workflow-oriented series of pages, the workflow related pages aredisplayed by the analytics server.

Page 400 g is an alternate embodiment of page 400 f. Because page 400 gis an alternate embodiment of page 400 f, page 400 g is not mandatory.The page 400 g may display additional or alternate information inadditional or alternate layouts. The analytics server may also displaythe graphical indicator 432G indicating the treatment area. Theanalytics server may also display a list of accessories necessary, asdepicted in graphical component 450G. The page 400 g may also includesetup notes, as depicted in the graphical component 453G andcorresponding images 454G.

Some of the graphical indicators on pages 400 f are similar to graphicalindicators on various other pages. For instance, text 425F may describeidentifying patient information. For example, the patient's first andlast name, patient identifier associated with the patient, and birthdatemay be displayed by the analytics server based on the RT file for theone or more patients and the patient scheduled for radiotherapytreatment. Further, graphical indicators 432F, describing the areas ofthe patient requiring treatment, may be displayed by the analyticsserver. Further, graphical indicators 430D indicating accessoriesnecessary for patient treatment may be displayed by the analyticsserver. In some instances, the analytics server may use statusindicators in conjunction with graphical indicator 430D to indicatewhether the analytics server has located the accessories.

Display notes 453F displayed by the analytics server may provide setupnote information. The display notes 436D in page 400 d (e.g., FIG. 4D)displayed by the analytics server may be further explained in thedisplay notes 453F in page 400 f. Further, the treatment related images454F might be displayed by the analytics server, for instance, toclarify the display notes 453F. For example, the treatment relatedimages 454F might convey illustrative examples of an accessory on aparticular patient being setup for treatment. Additionally, oralternatively, treatment related images 454F might convey illustrativeexamples of an accessory on a two-dimensional or three-dimensionalrepresentation (e.g., animation) of a patient being setup for treatment.The analytics server may also display the graphical indicator 432Findicating the treatment area. In some configurations, the informationdisplayed within the graphical indicator 432F may be different fordifferent treatment areas.

Graphical indicator 451F displayed by the analytics server may indicatean alert. For instance, an alert may be provided to the user to be awareof certain sensitive areas of the patient's body. The alert may beretrieved by the analytics server for instance, from the RT file. A user(e.g., a doctor) may identify certain sensitive areas of the patient'sbody or other treatment related information, and decide to alert adifferent user (e.g., a technician) to the supplemental treatmentrelated information at particular stages in the workflow. The analyticsserver may display the alert, indicating to the user that supplementaltreatment related information exists. The user may interact with thealert to receive the supplemental treatment related information. Forinstance, the analytics server may overlay the supplemental treatmentrelated information on the current page or on a separate page.Additionally, or alternatively, the analytics server may indicate to theuser where the user can retrieve the supplemental treatment relatedinformation indicated by the alert.

In some embodiments, the user who generated the alert may need toidentify themselves. For instance, a doctor generating the alert mayneed to sign the alert with the doctor's name, date and time that thealert was generated. Alternatively, a technician may need to sign thealert with their identification information upon reviewing thesupplemental treatment related information. Additionally, oralternatively, verification of the receipt of the supplemental treatmentrelated information indicated by the alert may need to be verified byone or more users, system administrators, and/or supervisors before theuser in the treatment room is allowed to progress to the subsequentstage in the workflow. For instance, a doctor may need to input aparticular input to verify that the technician has reviewed the alertbefore the technician is allowed to progress to subsequent stages.

Some of the graphical indicators on pages 400 g are similar to graphicalindicators on various other pages. For instance, text 425G may describeidentifying patient information. For example, the patient's first andlast name, and picture may be displayed by the analytics server based onthe RT file for the one or more patients and the patient schedule forradiotherapy treatment. Further, graphical indicators 432D, describingthe areas of the patient requiring treatment, may be displayed by theanalytics server. The analytics server may also display graphicalindicator 451G indicating an alert related to the patient. Further, theanalytics server may also display the graphical indicators 430Dindicating accessories necessary for patient treatment. In someinstances, the analytics server may use status indicators in conjunctionwith graphical indicator 430D to indicate whether the analytics serverhas located the accessories

Display notes 453F displayed by the analytics server may provide setupnote information. The display notes 436D in page 400 d (e.g., FIG. 4D)displayed by the analytics server may be further explained in thedisplay notes 453F in page 400 g. Further, the analytics server maydisplay the treatment related images 454F, for instance, to clarify thedisplay notes 453F. For example, the treatment related images 454F mightconvey illustrative examples of the accessory on the particular patientbeing setup for treatment. Additionally, or alternatively, treatmentrelated images 454F might convey illustrative examples of the accessoryon a two-dimensional or three-dimensional representation (e.g.,animation) of a patient being setup for treatment.

Referring now to FIG. 4H, the analytics server may display additionalpatient information on page 400 h based on an input 446E as shown inFIG. 4E. For instance, page 400 h may be considered a second page ofStage Two. The patient information in page 400 h may not be mandatorywithin the series of pages. That is, the user may never view page 400 hand the analytics server may not display page 400 h unless and untilrequired by the user (e.g., by an input). For instance, because page 400h may not be mandatory, in some radiotherapy treatment sessions, theuser may seek the additional patient information such the analyticsserver will display page 400 h. In other radiotherapy treatmentsessions, the user may not seek the additional patient information suchthat the analytics server will not display page 400 h. In contrast,during every radiotherapy treatment sessions utilizing theworkflow-oriented series of pages, the workflow related pages aredisplayed by the analytics server.

Some of the graphical indicators on pages 400 h are similar to graphicalindicators on various other pages. For instance, text 425H may describeidentifying patient information. For example, the patient's first andlast name, patient identifier, date of birth, and picture may bedisplayed by the analytics server based on the RT file for the one ormore patients and the patient schedule for radiotherapy treatment.

Display notes 460H displayed by the analytics server may provide alertsto the user. In some instances, the alerts may be extracted by theanalytics server based on the RT file for the one or more patients andthe patient scheduled for radiotherapy treatment. In other instances,the alerts may be based on doctor notes for the patient scheduled forradiotherapy treatment. The display notes 460H may display additionalalert information associated with graphical indicator 451F and/or 451G.

Graphical indicator 462H displayed by the analytics server conveys tothe user and/or patient the number of remaining radiotherapy treatments.In some instances, text may be displayed by the analytics server toconvey to the user and/or patient the number of remaining radiotherapytreatments. The number of remaining radiotherapy treatments may bedetermined by one or more doctors as an estimation of the number ofradiotherapy treatments the patient should undergo to rid the patient oftheir diagnoses. Additionally, or alternatively, the graphical indicator462H may indicate the number of remaining radiotherapy treatments formultiple diagnosed areas of the body.

Text 464H may convey information about the patient's upcoming medicalappointments. The upcoming medical appointments may be appointments withdoctors, appointments for radiotherapy treatments, appointments fortherapy, and the like. Text 464H may convey information about upcomingmedical appointments on the same day as treatment. Alternatively, text464H may convey information about upcoming medical appointments in thefuture.

Referring now to FIG. 4I, the analytics server may display additionalmachine information based on an input 444E as shown in FIG. 4E. Forinstance, page 400 i may be considered another example of a second pageof Stage Two. The machine information in page 400 i may not be mandatorywithin the series of pages. That is, the user may never view page 400 iand the analytics server may not display page 400 i unless and untilrequired by the user (e.g., by an input). For instance, because page 400i may not be mandatory, in some radiotherapy treatment sessions, theuser may seek the additional patient information such the analyticsserver will display page 400 i. In other radiotherapy treatmentsessions, the user may not seek the additional machine information suchthat the analytics server will not display page 400 i. In contrast,during every radiotherapy treatment sessions utilizing theworkflow-oriented series of pages, the workflow related pages aredisplayed by the analytics server.

Graphical indicator 427I on page 400 i may provide supplementalinformation to the information provided in graphical indicator 427D onpage 400 d. As discussed herein, in an embodiment, the graphicalindicator 427D displayed by the analytics server may represent more thanone safety feature associated with the treatment room. The analyticsserver may display various graphical indicators (427I1, 427I2, 427I3)associated with different interlocks. Status indicators may be displayedby the analytics server in conjunction with the graphical indicators(427I1, 427I2, 427I3). In an example, the graphical indicators (427I1,427I2, 427I3) may convey various interlocks in the treatment room.However, status indicators displayed by the analytics server inconjunction with the (427I1, 427I2, 427I3) may display that a firstinterlock is open, a second interlock is locked, and a third interlockis open. In the depicted example, the graphical indicator 427I1 mayrepresent a “beam not ready” status. The graphical indicator 427I2 mayindicate whether the analytics server has detected an “accessorymismatch” and the graphical indicator 427I3 may indicate whether thetreatment room is opened. As shown, none of the graphical indicators(427I1, 427I2, 427I3) are secure because the status indicators of eachof the graphical indicators (427I1, 427I2, 427I3) are visually distinct(e.g., displayed as orange).

Because none of the graphical indicators (427I1, 427I2, 427I3) aresecure, graphical indicator 427D on page 400 d in FIG. 4D, representingthe safety features generally, may have an orange status indicator. Theorange status indicator associated with graphical indicator 427D on page400 d in FIG. 4D may be displayed by the analytics server to convey tothe user that at least one graphical indicator (427I1, 427I2, 427I3)represented by graphical indicator 427D on page 400 d in FIG. 4D is notsecure. The user may transition to page 400 i to determine which one ormore safety features represented by graphical indicator 427D on page 400d in FIG. 4D is not secure.

Text 470I may convey information that identifies the radiotherapymachine performing the radiotherapy treatment. For instance, text 470Imay convey the name of the radiotherapy machine, the model of theradiotherapy machine, a software version that the radiotherapy machineis operating on, and the like. Graphical indicator 478I may indicate theprojected beam shape (e.g., an irradiated area) from the perspective ofthe collimator y. Graphical indicator 471J may also indicate the type ofbeam used during the radiotherapy treatment. Graphical indicator 476Imay display a two-dimensional or three-dimensional representation (e.g.,animation) representing the radiotherapy machine. Additionally, oralternatively, graphical indicator 476I may display a live view of theradiotherapy machine and/or the patient based on one or more camerasstreaming live feed data to the analytics server.

Graphical indicator 472I may indicate the radiotherapy machineparameters. The radiotherapy machine parameters may indicate asatisfactory position of the couch for treatment. The analytics servermay retrieve a position of the couch. A retrieved position of the couchmay be one or more couch positions satisfactory for treatment. Theretrieved position of the couch may be retrieved from memory of theanalytics server, retrieved by the analytics server from a database, orretrieved from within the RT file. The retrieved position may be athree-dimensional image (or model) of the couch. The analytics servermay employ various monitoring techniques (e.g., photogrammetry and/ortriangulation, as discussed herein) to compare images of thesatisfactory position of the couch for treatment to the retrievedposition of the couch to determine position vectors that may bedisplayed on page 400 i. The server may alternatively, or additionally,employ positional information retrieved from the treatment machine. Asdiscussed herein, the analytics server may display the magnitude (e.g.,extent of the difference) and direction (e.g., up, down, left, right,in, out, tilt in terms of pitch, roll to return the couch to thesatisfactory position for treatment) based on the difference between thesatisfactory position of the couch for treatment to the retrievedposition of the couch using numbers, arrows, colors, or somecombination. The analytics server may also display the numbersassociated with the retrieved position of the couch and the satisfactoryposition of the couch for treatment. Graphical indicator 472I may beused to align the patient and/or a part of the patient with asatisfactory position on the couch.

Additionally, or alternatively, the analytics server may display theextent of difference between the satisfactory position of the gantryand/or couch for treatment to the retrieved position of the gantryand/or couch using colors. For instance, the color yellow may indicate adifference greater than 10 mm, the color orange may indicate adifference between the subsequent image and reference image from 5-10mm, and the color grey may indicate a difference between the subsequentimage and reference image from 0-5 mm. The colors and associateddifferences between the subsequent image and reference image may bedetermined by a user and/or system administrator.

As opposed to describing the alignment of hardware (e.g., graphicalindicator 472I), text 473I may indicate software machine parameters suchas whether the analytics server (or a device in communication with theanalytics server) executes enhanced dynamic wedges. Additionally, oralternatively, text 473I may be represented by a graphical indicator.The analytics server may display on page 400 i the software machineparameters based on received inputs (e.g., from a user in a differentroom, from a user using the pendant, from instructions contained in theRT file). The analytics server may display a status indicator (e.g.,colors, shapes, borders) in conjunction with the graphical indicator(and/or text 473I).

Similarly, to the accessories displayed by the analytics server for thepatient text 474I may indicate hardware accessories required for theradiotherapy machine. Additionally, or alternatively, text 474I may berepresented by a graphical indicator. The analytics server may display(e.g., on page 400 i) the hardware accessories to be used during theradiation based on received inputs (e.g., from a user in a differentroom, from a user using the pendant, from instructions contained in theRT file). In some embodiments, instead of listing the hardwareaccessories required for the radiotherapy machine, the analytics servermay determine whether the hardware accessories are present on theradiotherapy machine.

For instance, the analytics server (or device in communication with theradiotherapy machine) may query one or more processors in theradiotherapy machine to perform a system check. Additionally, oralternatively, the analytics server may use the one or more cameras inthe treatment room and perform object detection on the live feed of datareceived by the analytics server. For instance, the server may useobject detection to determine whether hardware accessories are attachedto the radiotherapy machine. In alternate embodiments, the analyticsserver may use RFID technology as discussed herein to determine whetherthe hardware accessories are within a predetermined proximity.

In response to the system check performed by the radiotherapy machine(or the object detection or RFID utilized by the analytics server) theanalytics server may receive an indication of the attached hardwareaccessories present on the radiotherapy machine. The analytics servermay display a status indicator (e.g., colors, shapes, borders) inconjunction with the graphical indicator (and/or text 473I) to displayto the user the accessories detected on the radiotherapy machine. Insome cases, the analytics server periodically or continuously queriesthe radiotherapy machine for the presence and/or status of the hardwareaccessories. In some cases, the analytics server queries theradiotherapy machine for the presence and/or status of the hardwareaccessories based on an input received by the analytics server. Forinstance, the input received by the analytics server may be from aninteractive button pressed by the user on the pendant, a button pressedby a user on a console (the console discussed in FIGS. 10A-10D), abutton pressed by a user on the screen on the gantry, and the like.

In one configuration, a user may interact with interactive button 475Ito execute, by the analytics server, a dry run. In other embodiments,the dry run may be performed as a step just before treatment. That is,the analytics server may not display interactive button 475I and may notperform the dry run, or display information related to the dry run,until the next step (e.g., page 400 n of FIG. 4N representing StageFive, Patient Setup). In some embodiments, the dry run is a virtual dryrun. In other embodiments, the dry run is a physical dry run. In otherembodiments, the user may select the type of dry run to per executed bythe analytics server (e.g., a virtual dry run or physical dry run). Thevirtual dry run is described herein (e.g., FIGS. 6A-6G).

A user may interact with interactive button 477I to execute, by theanalytics server, one or more predetermined presets. The one or morepresets may be a collection of gantry and/or couch positions. Forinstance, a user may seek to maneuver the gantry and/or couch intovarious positions frequently. In the event the user interacts withinteractive button 477I, the gantry and/or couch may automaticallyadjust to one or more predetermined presets. The user may progressthrough the stages of the workflow faster because various predeterminedpresets allow the radiotherapy machine to automatically adjust tovarious positions accurately and quickly. It may be beneficial for auser to progress through the stages of the workflow faster because theradiotherapy treatment may take less time and be less burdensome on thepatient. A user and/or system administrator may determine thepredetermined preset positions.

Referring back to FIG. 4D, the user may progress to the next stage inthe workflow (e.g., the analytics server may display page 400 k of FIG.4K associated with Stage Three, Patient Identification) by completingthe current stage. In a non-limiting example, placing all of theaccessories in their appropriate positions may automatically trigger theanalytics server to determine move to the next stage of the workflow.Additionally, or alternatively, an interactive button may appear (orlight up) on the page 400 d such that the user is encouraged to interactwith the button In such instances, the analytics server may move to thenext stage of the workflow in response to the user interacting with theinteractive button.

FIG. 4J may be an alternate embodiment of FIG. 4I. For example, text470J may provide additional and/or alternate identifying informationabout the radiotherapy machine as compared to text 470I in FIG. 4I. Forinstance, text 470J may convey to the user the name of the radiotherapymachine, the version of the software installed on the radiotherapymachine, the year the radiotherapy machine was built, the lastinspection date of the radiotherapy machine, and the like. Text 471J mayconvey other identifying information about the radiotherapy machine suchas the accessories used on the radiotherapy machine, the set radiationintensity of the scheduled radiotherapy treatment, and the like. Furthertext 473J may convey additional identifying information about theradiotherapy machine such as the degree of rotation that theradiotherapy machine is capable of and/or a predetermined range ofrotation for the scheduled radiotherapy treatment. A user and/or systemadministrator may determine the range of rotation for the scheduledradiotherapy treatment.

The analytics server may display the set of graphical indicators 479J tohelp the medical professionals to identify needed accessories. As willbe described below, the analytics server may retrieve a list of allaccessories needed for the patient's treatment. Each graphical indicatorwithin the set of graphical indicators 479J may correspond to oneaccessory. As described herein, the analytics server may track differentaccessories (e.g., via RFID tags or visual tags) and may represent theaccessories located within a predetermined area as visually distinct.For instance, the analytics server may display the needed accessoriesthat are located within a certain proximity to the radiotherapy machinein different colors. The analytics server may continuously orperiodically monitor each accessory and may modify one or more of thegraphical indicator within the set of graphical indicators 479Jaccordingly.

Graphical indicator 472J may indicate the radiotherapy machineparameters as arrows (or other directional indicators) indicating thedirection of adjustment to reduce the difference between thesatisfactory position of the couch for treatment to the retrievedposition of the gantry and/or couch. As discussed herein, colors,graphical, and numerical representations conveying the differencebetween the satisfactory position of the gantry and/or couch fortreatment to the retrieved position of the gantry and/or couch may bedisplayed by the analytics server (in conjunction with graphicalindicator 472J as shown).

Further, some of the graphical indicators on pages 400 j are similar tographical indicators on various other pages herein. For instance,graphical indicator 478J may indicate the projected beam shape from theperspective of the collimator and/or the type of beam used during theradiotherapy treatment. Graphical indicator 476J may display arepresentation of the radiotherapy machine (e.g., two-dimensional model,three-dimensional model, live view, image, and the like).

Additionally, or alternatively, the analytics server may display theinteractive button 475J. As a result of the user interacting withinteractive button 475J, the analytics server may execute a dry runprotocol. Further, interactive button 477J may be interacted with,executing by the analytics server, one or more predetermined presets.

At step 414, the analytics server displays a page on a GUI representingStage Three. In this example, Stage Three relates to patientidentification. The analytics server can display patient identificationinformation (such as the patient's name and a photo) on the screen,increasing the likelihood that the user is engaged with the patient andthe treatment room, as opposed to looking down at papers or interactingwith the machine. The analytics server may display a portion of thetreatment data associated with the patient scheduled to receiveradiotherapy treatment. In some embodiments, the portion of thetreatment data associated with the patient scheduled to receiveradiotherapy treatment may help a user identify the patient.

The page 400 k in FIG. 4K displays the page displayed by the analyticsserver that corresponds to Stage Three (Patient Identification). Duringthe patient identification step, the patient may be allowed into thetreatment room. In other embodiments, in the event the patient isalready inside the treatment room, a user may match the patient in thetreatment room with the patient identification information displayed onthe screen.

Some of the graphical indicators on page 400 k may be similar tographical indicators on various other pages. For instance, text 425K maydescribe identifying patient information. For example, the analyticsserver may display the patient's first and last name, date of birth, andpicture based on the RT file for the one or more patients and thepatient schedule for radiotherapy treatment. Background 480K may be anon-treatment related image, a treatment related image, a solid color, apattern, and the like. The patient will likely view the background 480Kas the patient approaches the radiotherapy machine and views the screen.

In some embodiments, the analytics server will display the next stage inthe workflow when the patient identity is verified. For instance, theanalytics server may verify the patient using biometric identification(e.g., fingerprint, iris recognition, retina scanning). In someembodiments, the analytics server will display the next stage in theworkflow when the user performs one or more actions (e.g., uses one ormore interactive buttons to advance to the next stage).

At step 416, the analytics server displays a page on a GUI representingStage Four. In this example, Stage Four relates to patient alignment.The analytics server may display information to facilitate the patientgetting into a satisfactory position for treatment.

The user may progress to the next stage in the workflow (e.g., theanalytics server may display page 400 l of FIG. 4L associated with StageFour, Patient Alignment) by completing the current stage. For example,walking the patient over to the radiotherapy machine. Additionally, oralternatively, an interactive button may appear (or light up) on thepage 400 d such that the user is encouraged to interact with the buttonIn such instances, the analytics server may move to the next stage ofthe workflow in response to the user interacting with the interactivebutton. In other embodiments, the user may input any response to theanalytics server to progress to the next stage in the workflow. In someconfigurations, the analytics server may execute a virtual dry runprotocol. The analytics server may prevent the user to move to the nextstage until and unless the virtual dry run protocol indicates that thepatient will not collide with the radiation therapy machine.

The patient may be positioned in a satisfactory position for treatment.The satisfactory position for treatment may be indicated by positioninga particular area of the body in accordance with alignment data that isuniquely calculated for the patient. The alignment data may includevarious parameters indicating how a patient should be positioned on thecouch. Therefore, alignment parameters are not limited to alignmentangles. Although certain embodiments herein discuss displaying alignmentangles, it is expressly understood that the methods herein apply to allalignment data and parameters. For instance, alignment may be expressedin terms on a distance and a corresponding direction (e.g., 5 mm to theright).

The reference material may be a plurality of reference surfaces, imagesand/or attributes of a patient indicating regions of the patient to betreated (e.g., needing radiotherapy treatment). The reference materialmay indicate that a part of the patient's body in a satisfactoryposition for treatment. The satisfactory position for treatment may beindicated by positioning a particular area of the body at an alignmentangle(s) with reference to an isocenter or other reference points. Thepositioning of the particular area of the body at the alignment angle(s)allows the radiotherapy machine to radiate the positioned particulararea of the body while minimizing radiation exposure to other parts ofthe body and avoiding collisions during the treatment (because thepatient is aligned with respect to the reference position). Thealignment angle(s) (and corresponding satisfactory position fortreatment) may be predetermined by users and/or system administratorsand retrieved by the analytics server (for example, from the radiationRT file) and/or received by the analytics server as an input from theusers and/or system administrators. The analytics server may bemonitoring the position of the patient based on object tracking, asdiscussed herein. The analytics server may determine that the positionof the patient is acceptable if it is within a predetermined margin oferror.

Alignment angle, as used herein, may refer to aligning the patientconsistent with a patient position to receive optimal treatment. Forinstance, the patient's position may be aligned with a predeterminedsurface. Therefore, alignment angles refer to how the patient should bemoved. These movements may sometimes be characterized in angles andsometimes in other forms. Furthermore, alignment parameters are notlimited to alignment angles. For instance, the analytics server maydisplay various alignment parameters instructing a technician to realignthe patient accordingly. Therefore, even though certain embodimentsherein discuss displaying alignment angles, it is expressly understoodthat the methods herein may apply to all alignment data and parameters.

In some embodiments, the analytics server may display a referencesurface of a patient in an acceptable position for treatment. In somecircumstances, the reference surface may be a “ghost image” or a shadowof the patient in the acceptable position for treatment. Othernon-limiting examples of solutions may include joint position matching,body outline matching, and/or other surface matching techniques. Theserver may determine the position of the reference surface based on aretrieved reference surface. In some embodiments, the analytics servermay retrieve the reference surface from memory (e.g., the memory of theanalytics server may contain a library of acceptable positions forvarious treatment). For example, the analytics server may store aplurality of reference surfaces for patients needing radiotherapy totreat breast cancer in the left breast. Further, the server may store aplurality of reference surfaces for patients needing radiotherapy totreat breast cancer in the right breast. In other embodiments, theanalytics server may retrieve the reference surface from a database incommunication with the analytics server. In other embodiments, theserver may determine the position of the reference surface based onprior images of the patient during the patient's diagnoses procedure orprior treatments. For example, the analytics server (or other serverand/or device such as a camera) may have captured and stored an image ofthe patient during a first radiotherapy treatment. Additionally, oralternatively, the analytics server (or other server and/or device suchas a camera) may have captured an image of the patient during aprocedure associated with the patient's diagnoses (e.g., a CT scan). Formedical purposes, it may be critical to treat the patient in the sameposition such that the same part of the body is treated, increasing thelikelihood of successful treatments.

In other embodiments, the analytics server may retrieve a referencesurface from one of the plurality of stored reference surfaces from theRT file. The retrieved reference surface by the analytics server fromthe RT file is based on the treatment for the patient scheduled toreceive treatment (e.g., the selected patient in step 410).Additionally, or alternatively, a doctor or other user may save areference surface (or plurality of reference surfaces) based on CT scanor other image to the analytics server. In the event the analyticsserver receives an image, the analytics server may convert the imageinto a three-dimensional reference surface.

The Patient Alignment stage facilitates the patient's correct positionon the couch (e.g., not crooked, hands up, leg bent, and the like) toassist with receiving treatment at the proper location and angle and/orassist with avoiding interference with the radiotherapy machine.

In some instances, the reference surface may be overlaid on top of atwo-dimensional or three-dimensional representation (e.g., animation) ofthe radiotherapy machine. In other instances, the reference surface maybe overlaid on top of a live feed image of the radiotherapy machine(e.g., received by the analytics server from one or more cameraspositioned on the gantry and/or in the treatment room). The analyticsserver may display the overlaid reference surface. In other embodiments,the analytics server may use the reference surface only for internalcalculations.

A representation of the patient may be displayed on the screen such thatthe patient and/or the user can match the position of the patient to anacceptable position for treatment within a predetermined margin of error(the acceptable position of treatment determined by the referencesurface). The representation of the patient may be a live view of thepatient received by the analytics server from the one or more cameraspositioned on the gantry and/or the treatment room. Additionally, oralternatively, the representation of the patient may be atwo-dimensional or three-dimensional representation (e.g., animation).

The analytics server may compare the reference surface with therepresentation of the patient. As discussed herein, the analytics servermay determine a position vector based on the comparison of the referencesurface and the representation of the patient, indicating the differencein position of the patient to the reference surface. The analyticsserver may display the magnitude of the position vector using colors.For instance, the color red may indicate a difference greater than 10mm, the color orange may indicate a difference between the subsequentimage and reference image from 5-10 mm, and the color grey may indicatea difference between the subsequent image and reference image from 0-5mm. The colors and associated differences between the subsequent imageand reference image may be determined by a user and/or systemadministrator.

The analytics server may also overlay the representation of the patientwith one or more colors, patterns, textures, and the like. The overlaidrepresentation of the patient may be used to indicate the location ofthe patient relative to the reference surface. For example, apredetermined color may indicate that the patient is above the referencesurface, and a different predetermined color may indicate that thepatient is below the reference surface. Additionally, or alternatively,the analytics server may display the representation of the patient andthe reference surface without overlaying the reference surface and/orrepresentation of the patient respectively. For example, the analyticsserver may use the representation of the patient annotated and/orintersected with the reference surface.

The analytics server may also perform object tracking, as discussedherein, to track the position of the patient in three-dimensional space.The position of the patient may be compared to a three-dimensionalreference surface such that the analytics server can determine how theposition of the patient should be adjusted to match the position of thereference surface. The analytics server may display the position of thepatient compared to the position of the reference surface such that theuser and/or patient can see the adjustments that need to be made.Additionally, or alternatively, the analytics server may perform surfacematching to match the image of the patient (e.g., the image of thepatient in a frame) to the reference surface. The analytics server maymap the structures of the image of the patient to the reference surfaceand use an optimization function such as the least square error tooptimize the position of geometric attributes (such as metric, meancurvature, and textures) using the mapped image of the patient on thereference surface to determine how the image of the patient needs to beadjusted (e.g., in a next frame) according to the reference surface.

In the event that the analytics server determines the position of thepatient matches the position of the reference surface (within apredetermined margin of error), the analytics server may overlay theportion of the patient that matches (within the predetermined margin oferror) the reference surface a predetermined color.

Page 400 l displays the page displayed by the analytics server thatcorresponds to Stage Four (Patient Alignment). The page 400 m is analternate embodiment of page 400 l. The page 400 m may displayadditional or alternate information in additional or alternate layouts.

Some of the graphical indicators on page 400 l are similar to graphicalindicators on various other pages. For instance, text 425L may describeidentifying patient information. For example, the analytics serve maydisplay the patient's first and last name, date of birth, and patientidentifier based on the RT file for the one or more patients and thepatient schedule for radiotherapy treatment. Further, as discussedherein, graphical indicator 432L describes the areas of the patientrequiring treatment. As shown, one patient may have multiple areas ofthe body requiring treatment.

In addition, the analytics server may display graphical indicator 427Lrepresenting a safety feature associated with the treatment room. Insome embodiments, the graphical indicator 427L may represent one or moresafety features associated with the treatment room. In otherembodiments, various graphical indicators 427L (not shown) represent oneor more safety features in the treatment room. The graphical indicator427L representing a safety feature may be displayed by the analyticsserver in conjunction with a status indicator to convey what theanalytics server has identified as the status of the safety feature. Thestatus indicator may convey what the analytics server has identified asthe status of the more than safety features.

Further, as discussed herein, the analytics server may display graphicalindicator 428L representing machine alignment parameters. The machinealignment parameters may be used, for instance, by a user to evaluatewhether the gantry of the machine is aligned. In addition, graphicalindicator 496L may indicate the radiotherapy machine parameters. Theradiotherapy machine parameters may indicate a satisfactory position ofthe couch for treatment. As discussed herein, the analytics server maydisplay the magnitude (e.g., extent of the difference between thesatisfactory position of the couch for treatment to the retrievedposition of the couch) and direction (e.g., up, down, left, right, in,out, tilt in terms of pitch, roll to return the couch to thesatisfactory position for treatment).

Additionally, or alternatively, the analytics server may display theextent of difference between the satisfactory position of the gantryand/or couch for treatment to the retrieved position of the gantryand/or couch using colors. As shown, graphical indicator 496L isdescribed using arrows to indicate the direction of adjustment andnumber to indicate the extent of adjustment to achieve the satisfactoryposition for treatment. Further, graphical indicator 496L uses colors tofurther emphasize the extent of adjustment to achieve the satisfactoryposition for treatment. The patient (or a portion of the patient) may bealigned on the couch using the graphical indicator 496L such that thepatient (or a portion of the patient) is in a satisfactory position fortreatment.

Further, as discussed herein, the analytics server may use graphicalindicator 430L to display accessories necessary for patient treatment(e.g., as described in FIGS. 7A-7C). The analytics server displays thegraphical indicators 430L representing the accessories (and the statusof the accessories) on the side of the page 400 k such that theaccessories appear in a column. The analytics server may determine theaccessories necessary for the patient according to the RT fileassociated with the one or more patients. Additionally, the analyticsserver may use status indicators in conjunction with the graphicalindicator 430L indicating the accessories necessary for treatment todetermine whether the analytics server has located the accessory. Asshown, the status indicator is conveyed to a user by the color of thegraphical indicators 430L. The analytics server may determine thelocation of the accessory using technology, such as RFID (e.g., asdescribed in FIGS. 7A-7C).

Further, as discussed herein, the analytics server may display aprogress indicator 434L to indicate the stages of the workflow. Forexample, the current stage of workflow (e.g., Stage Four, PatientAlignment) may be emphasized by the analytics server such that a userand/or patient can determine the current stage of the workflow frompreceding or succeeding workflow stages displayed via the progressindicator 434L.

As discussed herein, Stage Four of the workflow beneficially facilitatesthe patient's correct position on the couch. The analytics server mayoverlay a reference surface on top of a two-dimensional orthree-dimensional representation (e.g., animation) of the radiotherapymachine and/or on top of a live feed image of the radiotherapy machine.The analytics server may receive the live view of the patient on thecouch from one or more cameras positioned on the gantry and/or thetreatment room. In some instances, the analytics server may generate anddisplay a three-dimensional model of the patient from the received liveview data using various monitoring techniques (e.g., triangulation, timeof flight, and/or photogrammetry as discussed herein). In otherinstances, the analytics server may display a live view feed of thepatient on the couch. The displayed view of the patient on the couch(e.g., either as a three-dimensional model or as a live feed) may beoverlaid with visually distinct areas 493L to facilitate the patient'scorrect position on the couch.

Visually distinct areas 493L are used to position the patient physicallyon the couch. For instance, the reference image may depict a patientwith their arms above their head. The analytics server may display thereference image to the patient overlaid on the couch such that thepatient is encouraged to match the position of the reference image.Overlaid visually distinct areas 493L on the patient may indicateadjustments required to position the patient according to the referenceimage. For instance, one color may indicate that part of the patient'sbody is below the reference surface. A different color may indicate thatpart of the patient's body is above the reference surface. The colorsand the associated meanings may be determined by a user and/or systemadministrator.

The user may interact with interactive button 497L to advance thedisplayed page (e.g., 400 l) to a next stage of the workflow (e.g., page400 n of FIG. 4N representing Stage Five, Patient Setup). As discussedherein, the analytics server may transition to a next workflow stage(e.g., page 400 n of FIG. 4N) based on whether the analytics serverdetermines that a predetermined portion of tasks displayed on page 400 lhave been completed. Additionally, or alternatively, the analyticsserver may transition to the next stage based on an input received fromthe user using a pendant and/or interacting with the displayed page 400l. The analytics server may use an interactive button such as button497L to transition to the next stage of the workflow on page 400 lbecause the next stage of the workflow, Stage Five, Patient Setup,involves the couch moving. Because Stage Five, Patient Setup involvesthe couch moving, it may be safer for the user to provide an input tothe analytics server such that the user has time to talk to the patientbefore the couch and/or gantry begin moving.

For instance, in the event the analytics server transitions to a nextstage based on the server determining that a predetermined portion oftasks have been completed (e.g., by determining that a certain number offlags and/or other indicators have been raised), the analytics servermay transition to the next stage of the workflow and subsequentlycontrol the couch and/or gantry to begin moving upon the patientadjusting to a proper position (the proper position determined by thereference surface). The patient may be surprised by the sudden movementand consequently move, changing their position and undoing the alignmentperformed in Stage Four of the workflow, Patient Alignment.

Some of the graphical indicators on page 400 m are similar to graphicalindicators on various other pages. For instance, text 425M may describeidentifying patient information. For example, the patient's first andlast name, patient identifier, and picture may be displayed by theanalytics server based on the RT file for the one or more patients andthe patient schedule for radiotherapy treatment. Further, as discussedherein, graphical indicator 432M describes the areas of the patientrequiring treatment. As shown, one patient may have multiple areas ofthe body requiring treatment.

Further, as discussed herein, the analytics server may display graphicalindicator 498M representing machine alignment parameters. The machinealignment parameters may be used, for instance, by a user to evaluatewhether the gantry of the machine is aligned. In addition, graphicalindicator 496M may indicate the radiotherapy machine parameters. Theradiotherapy machine parameters may indicate a satisfactory position ofthe couch for treatment. As discussed herein, the analytics server maydisplay the magnitude (e.g., extent of the difference between thesatisfactory position of the couch for treatment to the retrievedposition of the couch) and/or direction (e.g., up, down, left, right,in, out, tilt in terms of pitch, roll to return the gantry and/or couchto the satisfactory position for treatment) of the machine parameters.The patient (or a portion of the patient) may be aligned on the couchusing the graphical indicator 496M such that the patient (or a portionof the patient) is in a satisfactory position for treatment.

Additionally, or alternatively, the analytics server may display theextent of difference between the satisfactory position of the gantryand/or couch for treatment to the retrieved position of the gantryand/or couch using colors. As shown, the graphical indicator 496M isdescribed using arrows to indicate the direction of adjustment andcolors to emphasize the extent of adjustment to achieve the satisfactoryposition for treatment. For instance, the graphical indicator 496M mayconvey how the patient must move, such that the patient is aligned toreceive treatment.

Further, as discussed herein, the analytics server may use graphicalindicator 430M to display accessories necessary for patient treatment(e.g., as described in FIGS. 7A-7C). The analytics server displays thegraphical indicators 430M representing the accessories (and the statusof the accessories) on the side of the page 400 l such that theaccessories appear in a column. The analytics server may determine theaccessories necessary for the patient according to the RT fileassociated with the one or more patients. Additionally, the analyticsserver may use status indicators in conjunction with the graphicalindicator 430M indicating the accessories necessary for treatment todetermine whether the analytics server has located the accessory. Asshown, the status indicator is conveyed to a user by colored shapescontained within the graphical indicators 430M. The analytics server maydetermine the location of the accessory using technology, such as RFID(e.g., as described in FIGS. 7A-7C).

Further, as discussed herein, the analytics server may display aprogress indicator 434M to indicate the stages of the workflow. Forexample, the current stage of workflow (e.g., Stage Four, PatientAlignment) may be emphasized by the analytics server such that a userand/or patient can determine the current stage of the workflow frompreceding or succeeding workflow stages displayed via the progressindicator 434M.

Visually distinct areas 493M are used to position the patient physicallyon the couch. For instance, the reference image may depict a patientwith their arms above their head. The analytics server may display thereference image to the patient overlaid on the couch such that thepatient is encouraged to match the position of the reference image.Overlaid visually distinct areas 493M on the patient may indicateadjustments required to position the patient according to the referenceimage. For instance, one color may indicate that part of the patient'sbody is below the reference surface. A different color may indicate thatpart of the patient's body is above the reference surface. The colorsand the associated meanings may be determined by a user and/or systemadministrator.

In some embodiments, the analytics server may utilize an interactivebutton 497M to advance the displayed page (e.g., 400 m) to a next stageof the workflow (e.g., page 400 n of FIG. 4N representing Stage Five,Patient Setup). As discussed herein, the analytics server may transitionto a next workflow stage (e.g., page 400 n of FIG. 4N) based on whetherthe analytics server determines that a predetermined portion of tasksdisplayed on page 400 m have been completed. Additionally, oralternatively, the analytics server may transition to the next stagebased on an input received from the user using a pendant and/orinteracting with the displayed page 400 m. The analytics server may usean interactive button such as button 497M to transition to the nextstage of the workflow on page 400 m because the next stage of theworkflow, Stage Five, Patient Setup, involves the couch moving. BecauseStage Five, Patient Setup involves the couch moving, it may be safer forthe user provide an input to the analytics server such that the user hastime to talk to the patient before the couch and/or gantry being moving.For instance, in the event the analytics server transitions to a nextstage based on the server determining that a predetermined portion oftasks have been completed (e.g., by determining that a certain number offlags and/or other indicators have been raised), the analytics servermay transition to the next stage of the workflow and subsequentlycontrol the couch and/or gantry to begin moving upon the patientadjusting to a proper position (the proper position determined by thereference surface). The patient may be surprised by the sudden movementand consequently move, changing their position and undoing the alignmentperformed in Stage Four of the workflow, Patient Alignment.

Additionally, or alternatively, the analytics server may receive aninput from the user instructing the analytics server to execute avirtual dry run protocol. As a result, the analytics server may executethe methods described herein and determine whether the patient isprojected to collide with one or more parts of the radiation therapymachine. If so, the analytics server may prevent the workflow fromprogressing to a subsequent stage unless/until the patient is no longerproject to have a collision (e.g., the patient is realigned).

At step 417, the analytics server displays a page on a GUI representingStage Five. In this example, Stage Five relates to patient setup. Theanalytics server refines the patient's position from the PatientAlignment Stage. During the Patient Setup Stage (Stage Five), theradiotherapy machine may automatically move the couch to refine thepatient's manual position from the Patient Alignment Stage. Theanalytics server may refine the patient's manual position using thepatient's position data analyzed, as described herein. For instance, theanalytics server may execute surface matching techniques using patientimages received via the cameras (e.g., as described in FIGS. 5A-5C) tocalculate whether the patient must be realigned.

The analytics server may determine the movement of the gantry and/orcouch based on surface matching described herein (e.g., FIGS. 5A-5C). Inthe event that surface matching is performed, the analytics server maydisplay a representation of the two surfaces (e.g., the surface of thepatient overlaid on a reference image), where the representation of thesurface is displayed using an animation or using live feed data from thecameras in the treatment room and/or on the gantry (or some combinationof live feed data and animation). The analytics server may move thecouch based on the surface matching such that the surface of the patientmatches (or is within a predetermined margin of error) the surface ofthe reference image. The surfaces that are not matched may be displayedby the analytics server using a color or other types of visualizationtechniques (e.g., overly and highlighting intersections). In the eventthat the couch adjusts their position such that the surface of thepatient is matched (or is within a predetermined margin of error) with areference image, the analytics server will not display any color on thesurface of the patient.

Additionally, or alternatively, the surfaces that are matched may bedisplayed by the analytics server using a color. In the event that thecouch adjusts their position such that the surface of the patient ismatched (or is within a predetermined margin of error) with a referenceimage, the analytics server will display color over the entire surfaceof the patient. The analytics server may utilize other forms ofindicators to indicate whether the patient of the surface is matchedwith the reference surface (e.g., shading, borders, texture, and shine).

Additionally, or alternatively, the analytics server determines themovement of the couch based on optical alignment. For example, thelocation on a patient's body that is to be treated may be indicated(e.g., a user may draw on the patient's body). For instance, theanalytics server may display crosshairs drawn on the patient. In somecases, the analytics server adjusts (and/or communicates with anotherdevice to adjust) the couch such that the couch move to optically alignthe crosshairs with the radiation isocenter. In some embodiments, theanalytics server may move the couch, such that the patient's position iscloser to the required alignment whereby the user can realign thepatient for treatment. Therefore, the analytics server's repositioningmay be combined with the user's manual repositioning to align thepatient accordingly.

In the event the analytics server adjusts (and/or communicates withanother device to adjust) the couch according a predetermined margin oferror with respect to the reference surface, the analytics server maychange the displayed view of the patient. In some embodiments, theanalytics server displays the new view of the patient according tocameras that are closer to the treatment site. The analytics server mayfurther refine the position of the couch by adjusting the position ofthe couch (or being in communication with a device that adjusts theposition of the couch) based on the data received from the new view ofthe patient.

Additionally or alternatively, the analytics server may receive inputsfrom the user upon the completion of the refined treatment position ofthe gantry and/or couch. For example, a user may further adjust theposition of the couch (direct the gantry and/or couch up, down, left,right, in, out, tilt in terms of pitch, roll, and the like). Theseadjustments may be guided by the graphical indicators displayed by theanalytics server (e.g., 472N). The user may input the adjusted positionsof the gantry and/or couch using the pendant (as described in FIGS.3A-3B).

The page 400 n in FIG. 4N displays the page displayed by the analyticsserver that corresponds to Stage Five (Patient Setup). As discussedherein, Stage Five (Patient Setup) of the workflow. The focus of thepage in Stage Five of the workflow may change to a focus on the patient.For instance, the perspective of page may change from a couchperspective shown in page 400 d, page 400 l, page 400 m to a patientbody perspective in page 400 n.

The analytics server may guide (or communicate with a device thatguides) the movement of the couch and/or gantry based on various guidingprinciples. For example, the analytics server may guide the couch and/organtry based on surface matching (as described in FIGS. 5A-5C). In adifferent example, the analytics server may guide the couch and/organtry based on optical alignment. As shown, page 400 n describes anoptical, laser-based, setup of a portion of the patient on the couch.

Graphical indicator 410N represents the analytics server executingsurface matching on the patient on the couch to align the patientaccording to the satisfactory position for treatment (e.g., positionaland angular alignment). As shown, graphical indicator 410N representsthat the surfaces are not matched because analytics server is visuallydifferentiating unmatched portions of a patient (or other representationof the patient) and a satisfactory position for treatment. In the eventthat the couch adjusts their position such that the surface of thepatient is matched (or is within a predetermined margin of error) withthe reference image, the analytics server will not visuallydifferentiate any surface of the patient (or other representation of thepatient). As discussed above, the analytics server may use a variety ofmethods to visualize the position discrepancies (e.g., overly andhighlighting intersections).

In a non-limiting example, after the analytics server has performedsurface matching and aligns the patient such that the patient is in thesatisfactory position for treatment, the analytics server may capturethe position of the patient. The analytics server may continuouslymonitor whether the patient adjusts from the captured position. In theevent that a patient's adjustment exceed a predetermined margin of error(for instance, adjustments to the patient's position by breathing may beadjustments within the predetermined margin of error) the analyticsserver may display page 400 o in FIG. 4O. Additionally, oralternatively, the analytics server may only display page 400 o in FIG.4O in the event that the patient's adjusted position exceeds apredetermined margin of error for a predetermined duration of time. Forinstance, if the patient takes a deep breath and exceeds thepredetermined margin of error, but then returns back to the satisfactoryposition, the analytics server may not display page 400 o in FIG. 4O.

The page 400 o in FIG. 4O may include graphical indicators that aresimilar to graphical indicators on various other pages. For instance,display note 431O may use a graphical indicator (e.g., a hazard symbol)and text (e.g., a notice that the patient's position has changed) toconvey to the user that the patient's exceed a predetermined margin oferror. It should be noted that the display note may use other graphicalindicators as described herein. Page 400 o may also include text and/orgraphical indicators conveying PII as shown in 425O, an indication ofthe one or more areas of the patient requiring treatment as shown intext 432O, machine alignment parameters as shown in graphical indicator428O, radiotherapy machine parameters as shown in graphical indicator472O, and a progress of the user in the treatment room as shown inprogress indicator 434O (highlighting a current stage of the workflowprogression and displaying succeeding/preceding stages). Referring backto FIG. 4N, some of the graphical indicators on page 400 n are similarto graphical indicators on various other pages. For instance, text 425Nmay describe identifying patient information. For example, the analyticsserver may display the patient's first and last name, date of birth, andpatient identifier based on the RT file for the one or more patients andthe patient schedule for radiotherapy treatment. Further, as discussedherein, graphical indicator 432N describes the areas of the patientrequiring treatment. As shown, one patient may have multiple areas ofthe body requiring treatment.

In addition, the analytics server may display graphical indicator 427Nrepresenting a safety feature associated with the treatment room.Graphical indicator 427N is displayed by the analytics serverhorizontally on a side of page 400 n. The graphical indicator 427N mayrepresent one or more safety features associated with the treatmentroom. In the event the user wanted to know what safety features wererepresented by graphical indicator 427N, the user may have to input acommand to the analytics server such that the analytics server displaysadditional information regarding the safety features (e.g., input 444Ein FIG. 4E). The graphical indicator 427N representing a safety featuremay be displayed by the analytics server in conjunction with a statusindicator to convey what the analytics server has identified as thestatus of the safety feature. The status indicator may convey what theanalytics server has identified as the status of the more than safetyfeatures. As shown, the status of all of the safety features isacceptable (e.g., treatment door closed).

Further, as discussed herein, the analytics server may display graphicalindicator 428N representing machine alignment parameters. The machinealignment parameters may be used, for instance, by a user to evaluatewhether the gantry of the machine is aligned. Graphical indicator 428Nis displayed by the analytics server horizontally on a side of the page400 n.

In addition, graphical indicator 472N may indicate the radiotherapymachine parameters. The radiotherapy machine parameters may indicate asatisfactory position of the couch for treatment. Graphical indicator427N is displayed by the analytics server horizontally on a side of page400 n. As shown, graphical indicator 472N is described using arrows toindicate the direction of adjustment and number to indicate the extentof adjustment to achieve the satisfactory position for treatment.Further, graphical indicator 472N uses colors to further emphasize theextent of adjustment to achieve the satisfactory position for treatment.As shown, the patient is in a satisfactory position for treatment.

Further, as discussed herein, the analytics server may use graphicalindicator 430N to display accessories necessary for patient treatment(e.g., as described in FIGS. 7A-7C). The analytics server displays thegraphical indicators 430N representing the accessories (and the statusof the accessories) horizontally on the side of the page 400 n such thatthe accessories appear in a column. The analytics server may use statusindicators in conjunction with the graphical indicator 430N to determinewhether the analytics server has located the accessory. As shown, thestatus indicator is conveyed to a user by the color of the graphicalindicators 430N. The status indicator in conjunction with graphicalindicator 430N may convey that the accessory (Bolus 1) is not present.

The graphical indicators described herein may have two roles. Dependingon the type of the setup, the “satisfactory position” may be defineddifferently. For instance, in an optical setup, the satisfactoryposition may be with respect to the initial patient position ascalculated in Stage 4. In another example, the analytics server may usereal-time feedback from the SGRT cameras to determine the satisfactoryposition. The graphical indicators may allow the user to minimize thediscrepancy to the reference and ensure that the machine parameters arewithin the limits set in the treatment plan (indicated by orangehighlights or otherwise visually distinct).

Further, as discussed herein, the analytics server may display aprogress indicator 434N to indicate the stages of the workflow. Forexample, the current stage of workflow (e.g., Stage Four, PatientAlignment) may be emphasized by the analytics server such that a userand/or patient can determine the current stage of the workflow frompreceding or succeeding workflow stages displayed via the progressindicator 434N. As shown, the progress indicator 434N is horizontallylocated on the bottom of page 400 n.

Additionally, or alternatively, there may be an interactive button (notshown) that allows the user to perform a dry run (e.g., physical dryrun, virtual dry run) or capture a setup position. In some embodiments,upon capturing a setup position, the analytics server may execute thevirtual dry run to evaluate whether collisions will occur based on thesetup position. In the event the analytics server determines thatcollisions will not occur, the analytics server may perform the stepsassociated with Stage Six.

At step 418, the analytics server performs the steps associated withStage Six. In this example, Stage Six relates to treatment. Theanalytics server may turn off (or otherwise disable) the displays in thetreatment room to prevent the displays from being damaged by radiation.Upon completion of Stage Five, the screen can display a notice thattreatment is starting, and the screen can be disabled or turn off untilStage Six is complete.

The user may interact with interactive button 401N to advance thedisplayed page (e.g., 400 n) to a next stage of the workflow (e.g.,Stage Six, Treatment).

The analytics server shuts off the displayed screen on the gantry duringthe treatment stage of the workflow. Triggers for shutting off thedisplayed screen may include, but are not limited to, interacting withan interactive button (not shown), and closing the treatment door room.The analytics server turns on the screen on the gantry based on openingthe treatment door room, receiving a trigger from a device (e.g., theconsole), and the like. The analytics server may display the screencorresponding to the current workflow stage.

In some embodiments, upon completion of the treatment, a portion of theworkflow may repeat such that additional areas of the patient's body maybe treated. For example, the workflow may restart at Stage Two, suchthat the patient is realigned to receive treatment for a second bodypart. The user may use various workflow oriented GUIs described hereinto prepare the patient for additional treatments.

At step 419, the analytics server displays a page on a GUI representingStage Seven. In this example, Stage Seven relates to unloading thepatient. The analytics server adjusts (and/or communicates with anotherdevice to adjust) the couch and/or gantry into an ending position suchthat the patient is able to dismount from the couch.

In other embodiments, upon completion of the treatment, the workflow mayproceed to Stage Seven, Unload. FIG. 4P illustrates page 400 p of StageSeven, Unloading, according to an embodiment. Some of the graphicalindicators on page 400 p are similar to graphical indicators on variousother pages. For instance, text 425P may describe identifying patientinformation. For example, the patient's first and last name, date ofbirth, and patient identifier may be displayed by the analytics serverbased on the RT file for the one or more patients and the patientschedule for radiotherapy treatment.

Additionally, or alternatively, the workflow may proceed to Stage Sevenat any time based on the user's input. For instance, the user (at anytime) may interact with the unload button on the pendant (button 336)and the workflow proceeds to the unload stage. This option is availableat any point in the workflow, such that the user is able to extract thepatient from treatment position in case of emergency.

Graphical indicator 462P displayed by the analytics server conveys tothe user and/or patient the number of remaining radiotherapy treatments.As shown, the graphical indicator 462P may indicate the number ofremaining radiotherapy treatments for multiple diagnosed areas of thebody. Further, graphical indicator 462P is displayed horizontally in themiddle of the page. In alternate embodiments, the number of remainingradiotherapy treatments for multiple diagnosed areas may be verticallystacked instead of horizontal, as shown.

Text 464P may convey information about the patient's upcoming medicalappointments. The upcoming medical appointments may be appointments withdoctors, appointments for radiotherapy treatments, appointments fortherapy, and the like. Text 464P may convey information about upcomingmedical appointments on the same day as treatment. Alternatively, text464P may convey information about upcoming medical appointments in thefuture.

Background 480P may be a non-treatment related image, a treatmentrelated image, a solid color, a pattern, and the like. The patient willlikely view the background 480P as treatment completes and the gantryand/or couch are being adjusted such that the patient can exit theradiotherapy machine. In some embodiments, background 480P may be thesame background as in page 400 k in FIG. K. In alternate embodiments,background 480P may be a different background as in page 400 k in FIG.K.

Surface Matching

FIG. 5A illustrates a flowchart depicting operational steps performed bythe analytics server in accordance with an embodiment. The method 500 adescribes how a server, such as the analytics server described in FIG.1A, displays various interactive pages configured to display surfacematching performed on a patient (e.g., a person to be treated by theradiotherapy machine). Even though the method 500 a is described asbeing executed by the analytics server, the method 500 a can be executedby any server(s) and/or performed locally using a computer/processorassociated with the radiotherapy machine and/or the console (asdiscussed in FIGS. 11A-11L). Other configurations of the method 500 amay comprise additional or alternative steps, or may omit and/or mix oneor more steps altogether.

At step 502, the analytics server retrieves, from a RT file associatedwith a patient, information about a particular patient. The particularpatient may be the patient being treated by the radiotherapy machine.The information about the particular patient may include surfacematching information such as reference material. The reference materialmay include data associated with an alignment angle(s) for treatment ofa region of a body. The RT file containing information about aparticular patient may be retrieved from one or more medical databases(such as the medical database in FIG. 1A), servers, files, and the like.

The RT file may comprise a patient identifier. The patient identifiermay be a series of numbers and/or letters to identify patients. A user(e.g., technician, doctor, nurse, or other professional) and/or systemadministrator may determine the patient identifiers and map the patientidentifiers with particular patients. Additionally, or alternatively,the analytics server may update the RT file such that the RT filecontains the mapped patient identifiers and associated patients.Additionally, or alternatively, the analytics server may store themapped patient identifiers and associated patients.

The RT file may further include various treatment details associatedwith the patient's treatment. For instance, the RT file may includevarious couch/gantry attributes, such as couch angles, gantry rotationattributes (e.g., full or partial arcs), the number of partial arcs (ifapplicable), control points, and the like associated with each patient.In an example, the RT file may include the amount of dose delivered tothe patient at each determined control point of the planned machineposition.

In addition, the RT file may contain patient information, including PIIsuch as the diagnoses of the patients, the name of the patient,nicknames of the patient, the birthdate of the patient, one or morephotos of the patient, and the like. The RT file may also contain notesfrom one or more doctors regarding the patient and/or the diagnoses ofthe patient, and medical diagnoses tools such as x-ray scans, includingcomputed tomography (CT) scans, ultrasound images, and the like. The RTfile may also include whether the treatment is a VMAT treatment or IMRTtreatment.

Additionally, or alternatively, the analytics server may retrieveinformation contained within the RT file from one or more source. Forinstance, the patient identifier may be retrieved by the analyticsserver from a medical database (such as the medical database in FIG.1A), the treatment details associated with the patient's treatment maybe retrieved from a doctor's file. Additionally, or alternatively, theanalytics server may retrieve various portions of information fromvarious source. For instance, patient identifiers and treatment detailsassociated with the patient's treatment may be retrieved by theanalytics server from a medical database (such as the medical databasein FIG. 1A). Moreover, some PII may be retrieved by the analytics serverfrom a patient file, while other PII may be retrieved by the analyticsserver from a library.

As discussed herein, the RT file may contain reference material. Theanalytics server may retrieve the reference material from the RT file.Additionally, or alternatively, the analytics server may generatereference material based on the various treatment details associatedwith the patient's treatment, patient attributes, and the like. Forinstance, the analytics server may be in communication with one or moreservers, databases and/or devices to enable the analytics server accessto files, notes, and the like. Additionally, or alternatively, theanalytics server may receive the reference material from one or morethird parties (e.g., vendors, other hospitals, other clinics, and thelike).

The reference material may be a plurality of reference surfaces, imagesand/or attributes of a patient indicating regions of the patient to betreated (e.g., needing radiotherapy treatment). The reference materialmay indicate that a part of the patient's body in a satisfactoryposition for treatment. The satisfactory position for treatment may beindicated by positioning a particular area of the body at an alignmentangle(s) with reference to an isocenter or other reference points. Thepositioning of the particular area of the body at the alignment angle(s)allows the radiotherapy machine to radiate the positioned particulararea of the body while minimizing radiation exposure to other parts ofthe body and avoiding collisions during the treatment (because thepatient is aligned with respect to the reference position). Thealignment angle(s) (and corresponding satisfactory position fortreatment) may be predetermined by users and/or system administratorsand retrieved by the analytics server (for example, from the RT file)and/or received by the analytics server as an input from the usersand/or system administrators.

The reference material may be various patient attributes. For example,the analytics server may use measurements of the patient's body todetermine that the patient is aligned according to the alignmentangle(s). The analytics server may determine the measurements of thepatient's body based on one or more cameras or other devices feeding theanalytics server images and/or live video data. Additionally, oralternatively, a user may input patient measurements such that theanalytics server receives measurements of the patient's body. Theanalytics server may also retrieve measurements of the patient's bodyfrom the RT file or other one or more servers, files and/or databases.

The reference material may be a reference surface. For example, areference surface may illustrate a proper position for treatment(determined by the alignment angle(s)) of treating a particular patientwith breast cancer in their left breast. The reference surface may be asurface of the particular patient. For instance, the reference surfacemay be a three-dimensional model of the particular patient (e.g., ananimation). The analytics server may retrieve a reference surface of thepatient from the RT file, one or more databases, servers, files, thirdparties, and the like. Additionally, or alternatively, the analyticsserver may generate a reference surface of the patient based oninformation retrieved from RT file, one or more databases, servers,files, third parties, and the like.

Additionally, or alternatively, the reference surface may be a surfaceof a model patient. For instance, the model patient may be a patientbeing treated for breast cancer in their left breast (e.g., not theparticular patient being treated for breast cancer in their leftbreast). Additionally, or alternatively, the model patient may berendering of a patient positioned in a satisfactory position fortreatment for treatment of cancer in the left breast and/or a userdemonstrating a satisfactory position for treatment for breast cancer inthe left breast. Additionally, or alternatively, the reference surfacemay be a three-dimensional model (e.g., an animation) of the modelpatient, in a satisfactory position for treatment of cancer in the leftbreast. Different perspectives of reference surfaces (e.g., of a modelpatient and/or particular patient to be treated) may be stored by theanalytics server.

The reference material may be a two-dimensional image. The referenceimage may be based on, for instance, prior images of the patient duringthe patient planning. For example, the analytics server (or other serverand/or device such as a camera) may have captured an image of thepatient during a procedure associated with the patient planning (e.g., aCT scan). It is beneficial to treat the patient in the same positionsuch that the same part of the body is treated, increasing thelikelihood of successful treatments.

In the event the analytics server retrieves a reference image, theanalytics server may convert the image into a three-dimensionalreference surface using for instance, photogrammetry. In an example, theanalytics server may execute photogrammetry to determinethree-dimensional measurements from a reference image. The scale of thereference image may be determined, for instance, by measuring variousdistance of the patient (e.g., length of arms, length of legs, width ofthe torso, and the like) and/or using patent attributes. The analyticsserver may associate the measured distances of the patient and/orpatient attributes with one or more reference images of patient. Theanalytics server may use the measured distances of the patient and/orpatient attributes to construct depths in the reference image (e.g.,converting the reference image into a reference surface).

Additionally, or alternatively, the reference material may be based on,for instance, a three-dimensional model of the patient generated usingdata collected from multiple perspectives of the patient's diagnosesmaterial. For example, a plurality of cameras may capture continuoustime series images of the patient during a procedure associated with thepatient's diagnoses (e.g., a three-dimensional CT scan and/orfour-dimensional CT scan imaging) from multiple perspectives. Theplurality of cameras may also capture a stream of video data frommultiple perspectives during the patient's diagnoses that the analyticsserver (or other device) may transform into frames. A frame can beconsidered a window of video data of a fixed duration of time.

Images of the patient may be captured using one or more cameras (orother devices capable of producing an image). The images of the patientmay be captured when the patient is positioned on a couch of aradiotherapy machine. Additionally, or alternatively, athree-dimensional model of the patient positioned on the couch may becaptured and/or generated by the analytics server based on thecontinuous time series images or frames of video data from multipleperspectives. Multiple perspectives of the patient may be captured by aplurality of cameras. As described in FIGS. 2A-2F, the analytics servermay be in communication with a plurality of cameras (e.g., couch camera,gantry camera, or other cameras places within the radiotherapy room).The analytics server may use various methods (e.g., time of flightand/or triangulation) to generate a three-dimensional model of thepatient from the plurality of cameras using continuous time seriesimages or frames of video data.

In some configurations, the system may use structured light scanningtechnology, and/or time of flight technology, and/or any other knownthree dimensional imaging technology to analyze the patient's positionson the couch.

As an example, the analytics server may associate a two-dimensionalpixel in the continuous time series images or frames of video data witha ray in three-dimensional space. Given multiple perspectives of thecontinuous time series images or frames of video data (e.g., at leasttwo sets of continuous time series images or frames of video datacapture the position of the patient from at least two differentperspectives), a three-dimensional point can be obtained as theintersection of at least two rays from pixels of the continuous timeseries images or frames of video data.

The analytics server may execute various consistency functions todetermine that the rays from the continuous time series images or framesof video data are associated with consistent pixels. For instance, apixel from a first perspective of an image, mapped to athree-dimensional point using a ray based on the first perspective ofthe image, is consistent with a pixel from a second perspective of animage mapped to the same three-dimensional point using a ray from thesecond perspective of the image. The analytics server may determine fromthe consistency functions, whether the pixels used to determine thethree-dimensional point are similar colors, for instance.

At step 504, the analytics server may present for display on a graphicaluser interface, an image corresponding to the patient positioned on acouch of a radiotherapy machine, the image comprising an overlay on asurface of the patient in the treatment region. The analytics serverdisplays a graphical user interface (GUI) on a screen associated withthe radiotherapy machine (e.g., the screen positioned on the gantry asdescribed in FIGS. 2A-2F). The screen may be placed onto (otherotherwise connected to) the radiotherapy machine itself, such as byplacing the screen on the throat (or any other part) of the gantry. Thescreen may instead be placed in the treatment room (e.g., the same roomas the radiotherapy machine). Various other screens may display the GUIdisplayed by the analytics server. For instance, screens in roomsoutside of the treatment room (such as a room monitoring the treatmentroom) may display the GUI displayed by the analytics server.Additionally, or alternatively, the GUI may be displayed on variousplatforms. For instance, a user may view the GUI displayed by theanalytics server on the various platforms by executing an applicationsuch as a browser application.

The analytics server may display on a page of the GUI a representationof the patient on a couch of the radiotherapy machine. Therepresentation of the patient may be a three-dimensional model (revisedin real time or near real time) of the patient generated by theanalytics server, a live view of the patient received by the analyticsserver from one or more cameras, an image of the patient, or the like.The representation of the patient may capture the patient positioned onthe couch of the radiotherapy machine.

The GUI may overlay (superimposed layers) the reference surface on topof the representation of the patient. For example, the reference surfacemay appear as a “ghost” surface (e.g., a translucent surface).Additionally, or alternatively, the representation of the patient may beoverlaid on top of the reference surface. The GUI displays the overlaidreference surface and representation of the patient on a page of theGUI.

In one configuration, the GUI may not display the overlaid referencesurface and representation of the patient on the page, and the analyticsserver may use the reference surface and representation of the patientfor calculations and processing. The GUI may display either thereference surface or the representation of the patient on the page.Additionally, or alternatively, in such configurations, the analyticsserver may display either the reference surface or the representation ofthe patient on the page only in the event the surfaces are not matchingwithin a predetermined error (e.g., the reference surface does not matchwithin a predetermined error the representation of the patient).Additionally, or alternatively, the GUI could also display only selectedinformation resulting from the calculation and processing that isrelevant for the given stage of the treatment, e.g., breathing curveduring gated or DIBH treatments.

In step 506, the analytics server may present for display, a visuallydistinct revised overlay for at least a portion of the surface of thepatient in the treatment region that matches, within a predeterminedmargin of error, the alignment data. The analytics server may present arevised page for display. The revised page may indicate whether theposition of the representation of the patient matches (within apredetermined margin of error) the reference surface. Additionally, oralternatively, the revised page may indicate whether the position of thereference surface matches (within a predetermined margin of error) therepresentation of the patient. The predetermined margin of error may bedetermined by a user and/or system administrator. For example, the areaneeding radiotherapy treatment (e.g., the treatment region) may becompared to the alignment angle(s) for treatment. The analytics servermay perform surface matching to determine whether the position of therepresentation of the patient matches (within a predetermined margin oferror) the reference surface (or whether the position of the referencesurface matches (within a predetermined margin of error) therepresentation of the patient).

In one example, a surface of the patient derived from the position ofthe representation of the patient from the generated three-dimensionalmodel may be matched to the reference surface because the two surfaceshave the same underlying geometry. For instance, the underlying geometryof a treatment region of a male patient's torso likely will not changefrom being captured during planning (e.g., represented by a referencesurface) to being captured in preparation for treatment (e.g.,represented by a three-dimensional model representation of the patienton the couch).

In another example, a surface of the patient derived from the positionof the representation of the patient from the live feed of the patienton the couch may be matched to the reference surface because the twosurfaces have the same underlying geometry.

The analytics server may map the points from the generatedthree-dimensional model to corresponding points on the referencesurface. For instance, points in a point cloud corresponding to a firstmodel (e.g., the generated three-dimensional model) may be rotated andtranslated such that the points in the point cloud corresponding to thefirst model may be mapped to points in a point cloud of a second model(e.g., the reference surface). That is, the model of the patient may berotated into the point cloud of the reference surface. In an example,the iterative closest point algorithm (ICP) maps and translates pointsof the first model to points in the second model by iterativelydetermining closest corresponding points of the first model on thesecond model. The determination of the closest corresponding points maybe optimized using an optimization function such as the least squareerror to optimize the position of points every iteration. Othergeometric attributes (such as metric, mean curvature, and textures) maybe mapped from the first model to the second model.

The analytics server may perform surface matching in real time (or nearreal time) such that the patient and/or user can visually identify thedifferences between the positions of the representation of the patient(revised in real time and/or near real time based on the patient'smovements) and the reference surface (e.g., the satisfactory positionfor treatment based on the alignment angle(s)). The analytics server mayindicate the differences between the representation of the patient andthe reference surface by overlaying the reference surface and/orrepresentation of the patient using one or more colors. The one or morecolors can be used on the GUI to represent whether the position of therepresentation of the patient matches (within the predetermined marginof error) the satisfactory position for treatment (indicated by thealignment angle(s) optimized for treatment represented by the referencesurface). Additionally, or alternatively, the GUI can display anindication of the difference between the representation of the patientand the reference surface by overlaying the reference surface and/orrepresentation of the patient with patterns (e.g., hatch, stripes, anddots), textures, shininess, opaqueness or any other appropriate methodof visually distinguishing the reference surface from the representationof the patient.

Additionally, or alternatively, the GUI may indicate the differencebetween the representation of the patient and the reference surface byoverlaying a surface and/or object on top of the reference surfaceand/or patient. The overlaid surface and/or object may be overlaid oneor more colors to represent whether the position of the patient matches(within the predetermined margin of error) the satisfactory position fortreatment (indicated by the alignment angle(s) for treatment representedby the reference surface). Additionally, or alternatively, the analyticsserver may display the representation of the patient and the referencesurface without overlaying the reference surface and/or representationof the patient respectively. For example, the analytics server may usethe representation of the patient annotated and/or intersected with thereference surface . . . .

Referring now to FIGS. 5B-5C, non-limiting examples of the analyticsserver displaying surface matching on a representation of a patient aredepicted, according to an embodiment. In some embodiments, FIGS. 5B-5Care presented for display by the analytics server on a GUI. The GUI maybe displayed on a screen associated with a radiotherapy machine.

FIG. 5B illustrates an example page 500 b of the GUI displaying surfacematching, according to an embodiment. Model 510B is a graphicalrepresentation of a patient. In some embodiments, model 510B may be areference surface of the patient, where the reference surface derivedfrom one or more alignment angle(s)/locations of the patient in asatisfactory position for treatment. In other embodiments, model 510Bmay be a live view of the patient from one or more cameras in thetreatment room. As shown, model 510B is a three-dimensional (e.g.,animation) of a patient positioned on a couch of the radiotherapymachine.

The GUI may display the indicators 512B as an overlay to the model 510B.The GUI may present an overlay on the model 510B with an object and/orsurface having indicator 512B. Indicator 512B may be any suitable methodof visually distinguishing alignment information. The alignmentinformation may be determined from the surface matching performed by theanalytics server. For instance, the alignment information may representwhether the representation of the position of the patient matches (or iswithin a predetermined margin of error) the reference surface.

Additionally, or alternatively, the alignment information, based on theresults of the surface matching, may represent the extent to which therepresentation of the position of the patient matches (or is within apredetermined margin of error) the reference surface. The extent towhich the representation of the position of the patient matches thereference surface may be evaluated using the number of iterationsrequired for the ICP algorithm to map a closest point in therepresentation of the patient to a closest point in the referencesurface. For example, in the event that the analytics server uses ICP toperform surface matching, one or more thresholds relating to theiterations in the ICP algorithm may be determined. The thresholds may bedetermined based on a user and/or system administrator. For instance, inthe event that one-hundred or more iterations are required for the ICPalgorithm to map a closest point in the representation of the patient toa closest point in the reference surface, the analytics server maydetermine that the position of the patient (represented by therepresentation of the patient) is for instance, 50 cm away from thesatisfactory position for treatment.

As illustrated in this example, indicator 512B is a color (e.g., green)that is visually distinct from the surface color of the model 510B. Insome embodiments, indicator 512B may be a pattern, texture, color(s),and the like that is visually distinct from a pattern, texture,color(s), and the like used to identify model 510B. In otherembodiments, there may be multiple indicators. For example, an indicatorwith an associated visual pattern may indicate that part of thepatient's body is below the reference surface. A different indicatorwith a different associated visual pattern may indicate that part of thepatient's body is above the reference surface. The indicators and theirassociated meanings may be determined by a user and/or systemadministrator.

As shown in FIG. 5B, model 510B is nearly in a position satisfactory fortreatment. A patient and/or user may determine that model 510B is nearlyin a position satisfactory for treatment because indicator 512B ishardly visible. When the position of the patient is such that therepresentation of the patient (model 510B) matches the reference surface(or is within a predetermined margin of error), the GUI presents littleor no indicator 512B. The analytics server can recognize when thepatient is in a satisfactory position and indicate that position issatisfactory or that the next step is available.

Alternatively, when the position of the patient is such that therepresentation of the patient (model 510B) matches the reference surface(or is within a predetermined margin of error), the GUI can overlay thematched areas of the position of the patient to show a color indicatinga match rather than removing an overlay color where there is no match.

FIG. 5C describes an example page 500 c of the GUI displaying surfacematching, according to an embodiment. Model 510C may be similar inoperation and function as model 510B. Indicator 512C may be similar inoperation and function as indicator 512B. Model 510C is a graphicalrepresentation of a patient, and indicator 512C is a color that isvisually distinct from a color used to identify model 510C.

As shown in the example page 500 c, model 510C is not in a positionsatisfactory for treatment. A patient and/or user may determine thatmodel 510C is not in a position satisfactory for treatment becauseindicator 512C is very visible (e.g., there are significant portions ofthe patient's surface that covered in the overlay color. As shown, whenthe position of the patient is such that the representation of thepatient (model 510C) does not match (or is not within a predeterminedmargin of error) with the reference surface, the GUI will display usingindicator 512C (a color on the surface of the model 510C).

Alternatively, when the position of the patient is such that therepresentation of the patient (model 510C) does not match with thereference surface (or is not within a predetermined margin of error),the GUI can overlay the matched areas of the position of the patient toshow a color indicating a match rather than removing an overlay colorwhere there is no match.

Virtual Dry Run

FIG. 6A illustrates a flowchart depicting operational steps performed bythe analytics server in accordance with an embodiment. The method 600 adescribes how a server, such as the analytics server described in FIG.1A, presents for display a GUI having various interactive pagescorresponding to various stages of performing radiotherapy on a patient(e.g., a person being treated by the radiotherapy machine). Even thoughthe method 600 a is described as being executed by the analytics server,the method 600 a can be executed by any server(s) and/or performedlocally using a computer/processor associated with the radiotherapymachine and/or the console (as discussed in FIGS. 11A-11L). Otherconfigurations of the method 600 may comprise additional or alternativesteps, or may omit and/or mix one or more steps altogether.

Using the method 600 a, the analytics server may determine whether thepatient (or any devices attached to the patient) is projected to collidewith any part of the radiotherapy machine, such as any part of thegantry, couch, imagers, accessories, or even any unknown object detectedwithin the treatment room). Therefore, collision of the patient is notlimited to the collision of the patient with the gantry. As used herein,a patient (or a part of the radiotherapy machine) is projected tocollide with any part of the radiotherapy machine, when the patient (ora part of the radiotherapy machine) is within a planned trajectory ofthe radiotherapy machine.

The method 600 a is not limited to projecting whether the patient iswithin the planned trajectory of the radiotherapy machine (e.g.,collides with any part of the radiotherapy machine, such as the gantry,imager, or any other part of the radiotherapy machine). In someconfigurations, the analytics server may project that a part of themachine (e.g., imager) will collide with another part of the machine(e.g., couch).

At step 602, the analytics server may instruct one or more screens todisplay a page of the GUI. For example, the analytics server may presentfor display on a screen associated with the radiotherapy machine (e.g.,the screen positioned on the gantry as described in FIGS. 2A-2F). Thescreen may be placed onto (other otherwise connected to) theradiotherapy machine itself, such as by placing the screen on the throat(or any other part) of the gantry. The screen may also be placed in thetreatment room (e.g., the same room as the radiotherapy machine).Various other screens may display the pages presented by the analyticsserver. For instance, screens in rooms outside of the treatment room(such as a room monitoring the treatment room) may display the pagespresented by the analytics server. Additionally, or alternatively, theGUI may be displayed on various platforms. For instance, a user (e.g.,technician, doctor, nurse or other professional) or other third partymay view the GUI on the various platforms by executing an applicationsuch as a browser application.

The radiotherapy machine allows adjustment of the gantry and/or thecouch. For example, during non-coplanar treatment, both the couch andthe gantry adjust to various positions to maximize the radiationexposure to areas of the body requiring treatment and limit theradiation exposure to areas of the body that are healthy. Theradiotherapy machine may adjust positions of the couch and/or gantry forbased on executing a virtual dry run. For instance, the analytics servermay execute the virtual dry run protocol and determine that the patientis in risk of collision with the gantry. As a result, the analyticsserver may either prompt the user to move the couch (e.g., lower thecouch by an amount to avoid the possible collision), automatically movethe couch itself, or prompt the user to re-plan the treatment.

The analytics server may generate, receive, or retrieve a representationof a patient on the couch of the radiotherapy machine, representationsof the gantry, and/or representations of the couch (e.g., FIGS. 4A-4P).The analytics server may present for display on the GUI therepresentations of the patient on the couch of the radiotherapy machine,representation of the gantry, and/or representation of the couch.

The analytics server is in communication with a plurality of cameras(e.g., camera at an end of the couch, gantry camera, or other camerasplaced within the radiotherapy room and the like) to capture images,continuous time series images, point clouds, 3D surfaces, 3D models, orstreams of video data from one or more perspectives of the patient, theaccessories around the patient, the couch, and/or the gantry (e.g.,FIGS. 4A-4P). The analytics server may use any appropriate method ofgenerating models or images for the GUI to represent the patient on thecouch of the radiotherapy machine, the couch, and/or the gantry.Additionally, or alternatively, the analytics server may use the livefeed of data captured from the plurality of cameras from one or moreperspectives as representations of the patient on the couch of theradiotherapy machine, the couch, and/or the gantry.

Even though certain aspects of embodiments described herein describe theanalytics server receiving images and streams from the camera, it isexpressly understood that the methods described herein are not limitedto those embodiments. For instance, the analytics server may directlyreceive patient positioning data from the camera.

The analytics server may receive an input from a user to execute avirtual dry run or may automatically perform the dry run at appropriatetimes (e.g., between different stages). When the analytics serverexecutes the virtual dry run, the analytics server virtually stepsthrough satisfactory treatment positions of the couch position, gantryposition, and/or the patient position that will be performed duringtreatment. As discussed herein, the treatment positions of the couchposition, gantry position, and/or patient position may be retrievedand/or received by the analytics server (e.g., FIGS. 4A-4P). Forexample, satisfactory treatment positions, or machine trajectories, ofthe couch position, gantry position, and/or the patient position may beretrieved by the analytics server from one or more servers, databases,files, or the like.

The analytics server may predict collisions (or interference) that arelikely to occur based on the virtual dry run. Collisions predicted mayinclude, for example, collisions between the gantry and the couch,collisions between the gantry and the patient positioned on the couch,collisions between the gantry and one or more patient accessoriesrequired for treatment, collisions between the couch and the one or morepatient accessories required for treatment, and collisions between thepatient and the one or more patient accessories required for treatment.

At step 604, the analytics server may calculate one or more predictedcollisions between a part of the radiotherapy machine and at least oneof (a) the patient or (b) another part of the radiotherapy machine. Theanalytics server may determine whether any part of the patient (or theradiotherapy machine) is within the planned trajectory of theradiotherapy machine. The analytics server may project a collision basedon the positon of the patient (or a part of the radiotherapy machine)and the planned trajectory. The analytics server may use variouscollision detection methodologies to determine whether the patient (orany part of the radiotherapy machine) is within the planned trajectoryof the radiotherapy machine (e.g., gantry). For instance, the analyticsserver may determine a planned trajectory of the gantry based on thepatient's treatment plan and further determine if any of theradiotherapy machine (e.g., imager) or the patient (e.g., patient's arm)is within that trajectory.

In some configurations, the collision detection may be based on arepresentation of the patient positioned on the couch and arepresentation of the gantry (couch, or patient accessory) or itsplanned trajectory. The representation of the patient positioned on thecouch may be an image on the GUI of the patient positioned on the couchcaptured by one or more cameras. The representation of the patientpositioned on the couch may also be a generated three-dimensional modelof the patient positioned on the couch from the plurality of camerasusing continuous time series images or frames of video data.

The representation of the patient positioned on the couch may also beretrieved from stored images and/or models. For example, an image storedby the analytics server may be one or more prior images of the patientpositioned on the couch such as an image of the patient during thepatient's diagnoses procedure(s). For example, the analytics server (orother server and/or device such as a camera) may have captured an imageof the position of the patient during a procedure associated with thepatient's diagnoses (e.g., a CT scan). Further, as opposed to using animage captured by the analytics server (or other server and/or devicesuch as a camera) of an area of a particular patient to be treated, theimage stored by the analytics server may be an image of a model patientin a position on the couch. The model patient may be a rendering of apatient being treated based on a similar diagnosis to the particularpatient. Additionally, or alternatively, the stored image and/or modelof the patient positioned on the couch (or a model patient positioned onthe couch) may be retrieved by the analytics server from one or morethird parties, servers, databases, files and the like.

Additionally, or alternatively, the images and/or models stored by theanalytics server may be continuous time series images of the patientcaptured during a procedure associated with the patient's diagnoses(e.g., a CT scan) from multiple perspectives. The continuous time seriesimages may be captured for instance, by one or more cameras from aplurality of cameras and/or other devices capable of capturingcontinuous time series images of the patient. Additionally, oralternatively, one or more cameras (e.g., out of the plurality ofcameras) may capture a stream of video data from multiple perspectivesduring the patient's diagnoses procedure(s) that may be transformed intoframes. Further, as opposed to using continuous time series images orframes of video data captured by one or more cameras from multipleperspectives of an area to be treated of a particular patient, the imagestored by the analytics server may be based on a model patient in aposition on the couch, or on a 3D model of the patient.

Additionally, or alternatively, the stored image and/or model of thepatient positioned on the couch (or a model patient positioned on thecouch) may be retrieved by the analytics server from one or more thirdparties, servers, databases, files and the like.

The representation of the gantry (couch, or patient accessories) may bean image captured by the one or more cameras. Additionally, oralternatively, the representation of the gantry (couch, or patientaccessories) may be an image received by the analytics server by avendor, user, in-house designer, and the like. In some embodiments, theanalytics server may convert the image of the gantry (couch, or patientaccessories) to a three-dimensional model of the gantry (couch, orpatient accessories) using photogrammetry as described herein.

The representation of the gantry (couch, or patient accessories) may bea three-dimensional model generated by the analytics server employingvarious methods (e.g., time of flight and/or triangulation) oncontinuous time series images or frames of video data. Additionally, oralternatively, the representation of the gantry (couch, or patientaccessories) may be a three-dimensional model received by the analyticsserver by a third-party vendor, user, in-house designer, and the like.

In an example, the analytics server may use at least the representationof the gantry and the representation of the patient to determine whethera collision may occur between the gantry and the patient positioned onthe couch. Additionally, or alternatively, the analytics server may useat least the representation of the gantry and the representation of thecouch to determine whether a collision may occur between the gantry andthe couch. In alternate embodiments, the analytics server may combineone or more representations (the representation of the couch, therepresentation of the patient). Additionally, or alternatively, theanalytics server may modify one or more representations of the couch,gantry and patient before determining whether a collision will occur.For instance, a patient's clothing may become part of the representationof the patient and the patient's clothing may hang off the side of thecouch, creating the appearance of a collision of the patient and thecouch. The analytics server may crop and/or remove a portion of themodel of the patient that extends below a plane of the couch.

As an alternative to a 3-D or 2-D model, the analytics server mayproject the possible collision using geometric representations of thecouch, gantry, patient, and/or movement of the gantry. The analyticsserver may generate geometric shapes representing the patient, gantry,couch, and/or movement of the gantry. Additionally or alternatively, theanalytics server may retrieve geometric shapes of the representation ofthe patient, gantry, couch and/or movement of the gantry from one ormore servers, databases, files and the like. The analytics server mayuse these geometric shapes and apply various geometric models todetermine whether the shapes (representing the patient and/or differentparts of the radiotherapy machine) will collide.

The analytics server may determine whether a collision may occur betweenthe gantry and the patient. The analytics server utilizes a geometricmodel of the gantry and a three-dimensional point cloud of the positionof the patient, for instance, derived from the three-dimensional modelof the patient and/or retrieved from the analytics server from one ormore servers, databases, files, or the like. Additionally, oralternatively, the analytics server can evaluate whether variousportions of the patient will collide (or likely collide) with variousportions of the gantry or other components (e.g., accessory) of theradiotherapy machine.

The analytics server can determine whether a collision may occur betweenthe gantry and the patient by iteratively checking points in thethree-dimensional point cloud of the patient and determining, whethercoordinates of the three-dimensional point cloud of the position of thepatient are contained within (or intersect with) a portion of thegantry. For example, the head of the gantry may be geometrically modeledas a set of cylinders. The analytics server may determine whether pointsin the three-dimensional point cloud of the position of the patient areabove a bottom surface of a cylinder and below a top surface of thecylinder.

The analytics server may determine that a collision may occur near aportion of the head of the gantry when the one or more points in thethree-dimensional point cloud of the position of the patient are abovethe bottom surface of the cylinder and below the top surface of thecylinder. The analytics server may determine that a collision may notoccur near a portion of the head of the gantry when the one or morepoints in the three-dimensional point cloud of the position of thepatient are not above the bottom surface of the cylinder and below thetop surface of the cylinder. The analytics server may determine that acollision may not occur near a portion of the head of the gantry whenthe one or more points in the three-dimensional point cloud of theposition of the patient are above the bottom surface of the cylinder andnot below the top surface of the cylinder

Additionally, or alternatively, the analytics server may determinewhether the patient is projected to have a collision by evaluating howclose the points in the point cloud are to the surfaces of any part ofthe radiation therapy machine (e.g., a portion of the head of thegantry, couch, imagers, accessories or an unknown object detected withinthe treatment room). For example, whether the patient is projected tohave a collision may be determined by the analytics server based on theproximity of the three-dimensional point cloud of the position of thepatient to coordinates of the geometric shapes of the gantry. One ormore thresholds may be defined by users to determine proximitiesindicative of collision or non-collision. The analytics server may usethe ICP algorithm to iteratively loop through the points of thethree-dimensional point cloud of the position of the patient pointcloud.

The analytics server may iteratively check the three-dimensional pointcloud of the position of the patient and the geometric shaperepresentation of the gantry according to the treatment positions ofboth the gantry and the patient that will be executed during treatment.The treatment positions of the gantry such as the gantry angles may bedetermined from the treatment information retrieved from the RT file orthe one or more servers, databases and files. The treatment positions ofthe patient such as the alignment angles may be determined from thetreatment information retrieved from the RT file or the one or moreservers, databases and files.

Additionally, or alternatively, the analytics server may iterativelycheck the three-dimensional point cloud of the position of the patientand the shape defined by the movement of the gantry. For instance, theshape defined by the movement of the gantry may be a cylinder in whichone or more users have determined that anything inside of the cylinderwill not result in a collision during treatment. That is, the analyticsserver may determine whether a collision is projected to occur using acollision-free envelope of the projected path of the gantry.

The description for step 604 includes non-limiting examples of how theanalytics server can determine whether the patient may collide with thegantry during treatment. Other non-limiting examples of performingcollision detection can be found in U.S. Pat. Nos. 9,886,534,10,272,265, 10,166,406, 9,764,163, 10,493,298, 10,086,215, and10,073,438, and PCT application No. PCT/US2014/049078, each of which isincorporated by reference in its entirety.

At step 606, when a portion of the patient is calculated to be in acollision with the part of the radiotherapy machine, the analyticsserver may revise the graphical user interface such that the portion ofthe patient calculated to be in the collision is visually distinct inthe image.

The analytics server may update (in real-time or near real-time) theimage of the position of the patient on the couch of the radiotherapymachine. The analytics server may update the image of the position ofthe patient on the couch based on whether the analytics serverdetermines that a collision will occur, as (or after) the analyticsserver determines whether collisions will occur. The GUI may display, ona page having the image of the position of the patient on the couch,whether the patient is projected to have a collision. The GUI may alsodisplay whether the analytics server has determined the patient, gantryand/or couch will collide.

For example, the GUI may display that the patient (or a portion of thepatient) will collide (based on, for instance iteratively loopingthrough points of the three-dimensional patient point cloud anddetermining whether the points are contained within the geometric shapesof portions of the gantry) by marking the area of collision on thedisplayed representation of the gantry (according to the geometric shapeof the gantry). The analytics server may mark the area of collision onthe displayed representation of the gantry using colors, patterns,shininess, opaqueness, textures or other visually distinctiveidentifiers. Additionally, or alternatively, the analytics server maymark the area of collision on the displayed representation of thepatient using colors, patterns, shininess, opaqueness, textures or othervisually distinctive identifiers.

The analytics server may continuously/periodically monitor the patient'sposition (and/or position of the couch, gantry, and patient accessories)and may revise the displayed representations of the position of thecouch, gantry, and patient accessories described herein in real-time (ornear real-time). For instance, if the patient moves (after beingproperly positioned on the couch by the technician), certain portions ofthe patient's body may potentially collide with the gantry and/orpatient accessories. As a result, the analytics server may revise a page(e.g., upon receiving an instruction from the user, or upondetermination that a collision will occur) on the GUI indicating thatthe patient's new position has created a collision hazard.

In some embodiments, the analytics server may halt (or revise, such asby changing the speed) the movement of the gantry and/or the couch basedon determining that the patient will collide with any part of theradiotherapy machine.

Referring now to FIGS. 6B-6G, non-limiting examples of the analyticsserver displaying a GUI having pages based on a virtual dry run aredepicted, according to an embodiment. In other embodiments, theanalytics server may not display all of the pages described hereinand/or all the components of the page. For instance, the analyticsserver may display some (but not all) of the features described herein.The analytics server may display various combinations and configurationsof the pages depicted herein.

The pages depicted in FIGS. 6B-6G illustrate one or more pages displayedby the analytics server via a display on a gantry, as described in FIG.1A. The pages 600 b-600 f may use the same (or similar) graphicalelements as discussed herein. For example, graphical elements displayedby the analytics server may include graphical indicators, statusindicators, progress indicators, treatment related images, non-treatmentrelated images, backgrounds, live feeds of the radiotherapy machine, andnotes as discussed herein.

For instance, page 600 b may include text 610B, conveying PII, text 611Bindicating one or more areas of the patient requiring treatment,graphical indicator 616B (in conjunction with status indicators)indicating one or more safety features associated with the treatmentroom and/or console room, text 613B conveying hardware accessories(including medical devices), graphical indicator 615B representingmachine alignment parameters, and progress indicator 617B indicating theprogress of the user in the treatment workflow (e.g., highlighting acurrent stage of a workflow progression and displayingsucceeding/preceding stages) as described similarly to the graphicalelements in FIGS. 4A-4P.

Additionally, or alternatively, models 612B-D and 612F may represent thepatient on the couch of the radiotherapy machine displayed by theanalytics server. As shown, models 612B-D and 612F are three-dimensionalanimation representations of the patient. However, models 612B-D and612F may also be a live feed image of the patient as positioned on thecouch (or any other representation of the patient).

The analytics server may also employ one or more interactive buttons.Additionally, or alternatively, the analytics server may employ one ormore interactive buttons with multiple functions. For example,interactive button 619B may initiate the virtual dry run, pause thevirtual dry run program, restart the virtual dry run, and the like.

In the event the analytics server determines that a collision may occur,the analytics server may provide recommendations to the user to reducethe likelihood of the collision and/or eliminate the chance ofcollision. That is, the analytics server may coach (in real-time and/ornear real time) the user using visual indicators, such that the patient,for instance, is realigned accordingly. The analytics server mayaccomplish this task using a variety of methods.

In one example, the analytics server may identify a specific area of thepatient that would potentially collide with the gantry based on theresults of the virtual dry run as shown in page 600 f in FIG. 6F asdiscussed herein. The analytics server may then display the identifiedarea of the patient that might potentially collide with the gantry in avisually distinct manner that highlights the hazard. For instance, theanalytics server may display the identified area of the patient in adifferent color (or any other visually distinct manner, such as hatchpatterns).

In another example, the analytics server may display a list of one ormore areas of the patient that could potentially collide with thegantry. For example, the analytics server may display using text “leftarm” on the page 600 b and/or 600 c.

In yet another example, the analytics server may display the graphicalindicators 614B that can provide recommendations regarding how torealign the patient such that the risk of a possible collision iseliminated/reduced. For instance, the analytics server may displaygraphical indicators 614B as realignment parameters, coaching a userand/or patient on a direction and extent of direction (e.g., magnitudeand direction of a position vector determined by the analytics serverusing information associated with the virtual dry run) to realign thepatient, or a portion of the patient, on the couch. For example, theguidance provided by the analytics server may be focused on a particularbody part (e.g., move the elbow inwards).

In the event the risk of a possible collision is not eliminated/reduced,for instance, because a user does not realign the patient, the user maynot progress to a subsequent workflow stage (e.g., following theworkflow stages described in FIGS. 4A-4P)

As described above, the analytics server may visually identify any areaof the patient that could collide with the gantry. For instance, visualindicators 618B-D may be displayed by the analytics server (in real timeor near real time) in response to the virtual dry run results.

For example, as the analytics server determines whether a collision mayoccur between the patient and the gantry, the analytics server mayoverlay visual indicator 618B on the model 612B such that a user and/orpatient is visually aware of areas of collision and/or likely collision.The user and/or patient is made visually aware by the analytics serverbecause the analytics server uses visually distinct patterns (e.g.,hatch, stripes, and dots), textures, shininess, opaqueness or any otherappropriate method of visually distinguishing the model 612B from thevisual indicator 618B. For example, as depicted, the analytics serverdisplays the area 620B using a different color than area 621B becausethe analytics server has determined that the area 620B has a high riskof collision with the gantry and area 621B has a low risk of a collisionwith the gantry. Additionally, or alternatively, the analytics servermay identify one or more potential collision areas (e.g., 620B, 621B)with labels.

In some embodiments, as depicted in FIG. 6C, the analytics server mayonly display a direction in which the patient (e.g., model 612C) shouldbe moved for realignment. For instance, the graphical indicators 614Cindicate that the patient must be realigned in a specific direction(e.g., realignment directions). For instance, graphical indicator 622Cindicates that the patient must be moved to the left. The graphicalindicator 622 may be visually distinct from the graphical indicator 624C(using different colors or any other method). The visual differencesbetween graphical indicator 622C and graphical indicator 624C mayindicate that the patient must be moved in a direction corresponding tothe graphical indicator 622C. As described herein, the analytics servermay continuously monitor the patient's position. When the patient isrealigned, such that the analytics server no longer projects thatpatient is going to collide with the gantry, the analytics server mayrevise the graphical indicator 614C (in real-time or near real-time),such that it no longer indicates a necessity to realign the patient. Forinstance, the analytics server may display the graphical indicator 614Don page 600 d in FIG. 6D.

Page 600 c may also include graphical elements displayed by theanalytics server such as graphical indicators, status indicators,progress indicators, treatment related images, non-treatment relatedimages, backgrounds, live feeds of the radiotherapy machine, and notesas discussed herein.

For instance, page 600 c may include text 610C, including text thatconveys PII, and graphical indicator 615C representing machine alignmentparameters, as described similarly to the graphical elements in FIGS.4A-4P.

The analytics server may display a graphical indicator in orange, whichconveys that the patient is projected to have a collision unless thepatient is realigned. When the patient is realigned, the analyticsserver may recalculate whether the patient will have a collision and maydynamically change the color of the graphical indicator. For instance,an orange left arrow indicates that the patient must be moved to theleft or the patient will have a collision. When the patient is moved tothe left, the analytics server may remove the orange color from thegraphical indicator. Additionally, or alternatively, various visualdifferences may distinguish an extent of realignment. For example, agraphical indicator displayed in a particular color may indicate thatthe patient move a significant amount to reduce the likelihood ofcollision. In contrast, a graphical indicator displayed in a differentcolor may indicate that the patient move a smaller amount to reduce thelikelihood of collision. The patient may be considered aligned when thegraphical indicators no longer display orange.

As show in page 600 d, the patient and the couch have adjusted accordingto the guidance provided by the analytics server such that theradiotherapy machine parameters (e.g., graphical indicators 614D) andmachine alignment parameters (e.g., 615D) convey to a user and/orpatient that the likelihood of collision is smaller (or that theanalytics server does not predict that a collision will occur).

Page 600 d may also include graphical elements displayed by theanalytics server such as graphical indicators, status indicators,progress indicators, treatment related images, non-treatment relatedimages, backgrounds, live feeds of the radiotherapy machine, and notesas discussed herein.

For instance, page 600 d may include text 610D, including text thatconveys PII, and graphical indicator 615D representing machine alignmentparameters, as described similarly to the graphical elements in FIGS.4A-4P.

In some configurations, the analytics server may display additionalinformation regarding realignment of the patient. The realignment of thepatient may not be limited to realigning the patient. For instance,realignment recommendations may include realigning the machine as well.For instance, realignment parameters 614B-F may refer to the realignmentof the patient and/or the realignment of the machine (including thegantry and/or couch). For example, graphical indicator 615E may refer tothe realignment of the couch with respect to the pitch and roll of thecouch. When the analytics server receives a request from the user, theanalytics server may display the additional realignment information, asdepicted in FIG. 6E.

Page 600 e may also include text 624E that conveys identifyinginformation about the radiotherapy machine. The graphical indicator 616E(in conjunction with status indicators) may represent one or more safetyfeatures associated with the treatment room and/or console room. Thepage 600 e may also include text 630E and graphical indicator 632Edisplaying a representation of the radiotherapy machine, graphicalindicator 636E indicating the projected beam spread from the perspectiveof the collimator positioned on the gantry and/or the type of beam usedduring the radiotherapy treatment.

The graphical indicators 630E may represent interlocks and treatmentattributes. A non-limiting list of some possible different interlocks isdepicted in FIG. 6G. An interlock may represent an attribute of theradiotherapy machine, the treatment, and/or the treatment room.Interlocks may be customizable by a system administrator, clinicadministrator, and/or a medical professional. The analytics server maydisplay the graphical indicators 645G and 648G-655G depending on whethereach corresponding interlock has been satisfied. For instance, when aninterlock is satisfied or present (e.g., conditions regarding theinterlock has been met), the analytics server may display acorresponding graphical indicator or may distinguish the correspondingindicator (e.g., highlight or color change).

The graphical indicator 645G indicates whether the analytics server isin communication with the pendant and/or whether the pendant has beenplaced correctly on its holder within the treatment room. Properplacement of the pendant eliminates the chance of wire entanglementand/or damage by the machine motion, pendant dropping, and the like.

The graphical indicator 648G indicates whether the treatment room dooris closed. The graphical indicator 649G indicates that the analyticsserver has lost communication with one or more devices/featuresdescribed herein (e.g., radiotherapy machine, pendant, imagingapparatus, clinic server, and/or the console computers). The graphicalindicator 650G indicates whether the input elements (e.g., consolecomputers or the pendant) has been “locked,” such that users are nolonger able to interacts with the input elements to adjust the patient'streatment and/or one or more attributes of the radiotherapy machine.

The graphical indicator 651G indicates that the analytics server isprocessing (e.g., analyzing data) and will shortly provide results(e.g., provide new alignment angles). The graphical indicator 652Gindicates that the gantry is not set up properly (e.g., beam not ready).The graphical indicator 653G indicates that the collimator is not set up(e.g., not initialized). The graphical indicator 654G indicates that atleast one accessory is missing or cannot be identified by the analyticsserver. The graphical indicator 655G indicates that the patient (and/ora medical device connected to the patient) may collide (or has collided)with the gantry if the patient is not repositioned before the treatmentbegins. As will be described below, the analytics server may use variousmethods to determine a possible collision between the gantry and thepatient.

Referring now to FIG. 6E, The page 600 e may also include theinteractive button 632E executing by the analytics server a physical dryrun and/or a virtual dry run, and interactive button 634E executing bythe analytics server, one or more predetermined presets as describedsimilarly to the graphical elements in FIGS. 4A-4P. The analytics servermay also display realignment parameters 614E as described herein.

Additionally, or alternatively, the user may interact with interactivebutton 632E to repeat the virtual dry run process. As a result, theanalytics server may reevaluate whether the patient is projected to havea collision with the gantry, couch, and/or accessories. The user mayselect one or more virtual dry runs to execute using the analyticsserver.

Page 600 f in FIG. 6F illustrates the GUI identifying a specific area ofthe patient that may potentially collide with the gantry based on theresults of the virtual dry run, according to an embodiment. Graphicalindicator 642F is a message shown overlaying a portion of model 612Frepresenting the patient. As shown, graphical indicator 624F is avisually distinguished from model 612F because the analytics server hasoverlaid a color on graphical indicator 624F. A user and/or patientviewing the dry run page may be informed by display note 640F that apotential collision may occur on the right arm of the patient. Graphicalindicator 640F as shown includes graphical components (e.g., an alarmbell) and text (e.g., a warning conveying that a potential collision).However, the message may use other graphical elements (e.g., treatmentrelated images, live feed data, backgrounds, and the like) to convey tothe patient and/or user that a collision is likely to occur based on thedry run results. Text 641F may convey to the user and/or patient thatthe page displayed by the analytics server is a virtual dry run. Thepage 600 f may also include realignment parameters as depicted 614F.

Page 600 f may also include text 610F identifying the patient, conveyingPII, text 611F indicating one or more areas of the patient requiringtreatment, and graphical indicator 615F representing machine alignmentparameters. The page 600 f may also include progress indicator 617Findicating the progress of the user in the treatment room (e.g.,highlighting a current stage of a workflow progression and displayingsucceeding/preceding stages) as described similarly to the graphicalelements in FIGS. 4A-4P.

Identifying Required Accessories

FIG. 7A illustrates a flowchart of a method 700 depicting operationalsteps performed by a server, such as the analytics server described inFIG. 1A, in accordance with an embodiment. The method 700 describes howthe analytics server displays various interactive pages on a GUIconfigured to identify one or more accessories needed for a patient'streatment. Even though the method 700 is described as being executed bythe analytics server, the method 700 can be executed by any serverand/or performed locally using a computer/processor associated with theradiotherapy machine and/or the console. Other configurations of themethod 700 may comprise additional or alternative steps, or may omitand/or mix one or more steps altogether.

At step 710, the analytics server may retrieve radiotherapy fileassociated with a patient, the radiotherapy file comprising informationassociated with one or more accessories associated with the patient'sradiation therapy treatment. The analytics server may retrieve an RTfile associated with a patient, the RT file comprising an accessoryassociated with the patient's radiotherapy treatment. As describedabove, the analytics server may retrieve information associated with thepatient and the patient's treatment. The analytics server may query andretrieve a RT file associated with the patient identifier. The RT filemay include various treatment details associated with the patient'streatment. For instance, the RT file may include various couch/gantryattributes, such as couch angles, gantry rotation attributes (e.g., fullor partial arcs), control points, the number of partial arcs (ifapplicable), and the like. In some configurations, the RT file may alsoinclude whether the treatment is a VMAT treatment or IMRT treatment.

The RT file may also include a list of accessories needed to conduct thepatient's treatment. Accessories may refer to any medical equipmentrequired to treat the patient, for example to position and align thepatient in accordance with alignment angles. Non-limiting examples ofaccessories may include bolus material that is used during high-energyphoton and electron radiation treatments and placed over the treatedregion to deliver the full-prescribed dose to the skin surface as wellas underlining tissue. Other non-limiting examples accessories mayinclude tungsten shields, grip rings, various other shields, skin careaccessories, preloaded markers, clamps, digital level, skin markers,calipers, transfer boards, straps, fixing apparatus used to immobilizeparticular regions of the patient, isocenter-alignment apparatus, andthe like.

The list of accessories may be previously inputted by a treatingphysician, clinician, or any other medical professional. For instance, atreating oncologist may directly input the accessory name and attributes(e.g., size, shape, classification, type, and configurations) into aplatform where the data is captured and retrieved by the analyticsserver. In some configurations, the list of accessories are determinedand inputted by a technician. For instance, a technician may review thepatient's treatment plan and identify one or more accessories needed toimplement the patient's treatment.

Additionally, or alternatively, the analytics server may automaticallypopulate/determine the list of needed accessories for the patient basedthe patient's treatment plan. The analytics server may analyze thetreatment attributes retrieved (step 710) and may execute one or morepredetermined rules, protocols, and thresholds to identify a list ofnecessary accessories. For instance, the analytics server may determinethat straps and isocenter alignment apparatus is needed for a patientwho is receiving radiotherapy on his chest.

At step 720, the analytics server may present for display on thegraphical user interface, a graphical indicator corresponding to each ofthe one or more accessories. The analytics server may display an imageof a radiotherapy machine on a page. The analytics server may instructthe GUI associated with the radiotherapy machine to display a series ofpages on a screen associated with the radiotherapy machine. As describedabove, the screen may be placed onto (other otherwise communicativelycoupled to) the radiotherapy machine itself, such as by placing thescreen on the throat (or any other part) of the gantry. The screen mayalso be placed in the treatment room (e.g., the same room as theradiotherapy machine). In some embodiments, the screen displaying thepage may refer to the screen of monitoring devices placed in a separateroom (e.g., console placed outside of the treatment room, such as amonitoring room).

Various pages associated with the method 700 may be a part of a seriesof pages described herein (e.g., stage-based pages described in FIGS.4A-4P) or may be a standalone page that can be separately displayed(e.g., not as a part of a series of pages). Furthermore, the pagesdescribe herein may be displayed on multiple screens in a synchronous orasynchronous manner. For instance, the analytics server may displays thepages described herein on a GUI on the throat of the gantry,radiotherapy room screen, and/or console monitors, in a simultaneous ornear simultaneous manner, such that one or more users can monitor thetechnician's actions.

The GUI may display an image of the radiotherapy machine (e.g., couch).As described above, the analytics server may be in communication withone or more cameras (e.g., camera on the couch, gantry camera, or othercameras places within the radiotherapy room). The analytics server mayutilize a feed from the one or more cameras to display a live feed ofthe radiotherapy machine (e.g., live feed of the couch with or withoutthe patient).

At step 730, the analytics server may present for display on the page agraphical indicator corresponding to the accessory. The page may displaya graphical indicator associated with each accessory identified withinthe RT file. The graphical indicator, as used herein, may correspond toany graphical component (e.g., graphical icon or text) displayed on apage that indicates the need for a particular accessory. Non-limitingexamples of a graphical indicator may include icons in different shapes(e.g., rectangular, square, and circle) and/or in different colors(e.g., black, white, red, orange, and can be solid, opaque, ortranslucent).

The graphical indicator may include an indication corresponding to theaccessory identified as necessary for the patient's treatment. Forinstance, the analytics server may display a name associated with theaccessory. In other example, the analytics server may display a shapecorresponding to the needed accessory. For instance, the analytics severmay assign different shapes for different accessories (e.g., circle forgrip rings and triangles for boluses). Different shapes and theircorresponding accessories may be predetermined (e.g., system default) ormay be inputted by the end user (e.g., technician). The shapes and theircorresponding accessories may be revised by the end user (e.g., systemadministrator or technician).

At step 740, the analytics server may scan a set of accessories within apredetermined proximity to the radiotherapy machine. The analyticsserver may utilize various location tracking/scanning methods todetermine one or more accessories within a predetermined proximity tothe radiotherapy machine. The analytics server may use a defaultpredetermined proximity set up by a system administrator or specific toa clinic. The analytics server may also receive the predeterminedproximity and its reference point (e.g., two feet from the couch) fromthe system administrator or a technician or any other electronicdevice/feature descried in FIG. 1A. In some embodiments, thepredetermine proximity may refer to a specific location on the couch.

In one configuration, the analytics server may use RFID technology toidentify the locations of one or more accessories nearby (e.g., within apredetermined proximity to the radiotherapy machine). More specifically,the analytics server may use electromagnetic fields to automaticallyidentify and track RFID tags attached to different accessories. An RFIDtag consists of a radio transponder, a radio receiver, and transmitter.When triggered by an electromagnetic interrogation pulse from a nearbyRFID reader device, the RFID tag may transmit data back to the reader.The data may include a number (or other identifier) unique to aparticular accessory. The analytics server may utilize active and/orpassive RFID tags to identify locations of the accessories. The RFIDtechnology may include near field communication (NFC) or other relatedconfigurations. Alternatively, although the example utilizes RFID, othertechnology for determining the presence of a nearby object may be used,such as Bluetooth, beacons, ultra-wide band RTLS, GPS, Wi-Fi, computervision, and the like.

The analytics server may be in communication with one or more nearbyRFID readers, which can in turn communicate with one or more RFID tagsplaced onto each accessory devices. The analytics server may identify alocation and a range of each RFID reader. The analytics serveridentifies and accessory's location when the accessory's RFID tag isdetected within a particular RFID reader's range. In a non-limitingexample, the analytics server queries/activates an RFID reader placed onthe couch. As a result, the RFID reader communicates with all RFID tagswithin the RFID reader's range and transmits RFID tagnumbers/identifiers to the analytics server. The analytics server thenqueries a data table to identify an accessory associated with eachreceived RFID number to identify the corresponding accessory.

The analytics server may continuously or periodically monitor locationof the accessories (or a list of accessories within a predeterminedproximity to the radiotherapy machine), such that the analytics serverpossesses real time (or near real time) location information for eachaccessory.

Additionally, or alternatively, the analytics server may use visual tagsto identify a location of one or more accessories. The analytics servermay scan one or more visual tags present within the images of theradiotherapy (received from the cameras described herein) to identifywhether the necessary accessory is within a predetermined proximity tothe radiotherapy machine. Visual tag, as used herein, may refer toencoded images placed on the accessories, such as barcodes, quickresponse (QR) codes, and the like. The encoded images may represent dataassociated with its corresponding accessory (e.g., type, category, andmodel). The encoded image may be in a machine-readable format, such thatthe analytics server can identify and scan the visual tag within thereceived images and identify the corresponding accessories presentwithin the image.

In a non-limiting example, the analytics server receives a live feed ofthe couch from a camera placed on the gantry. The analytics servercontinuously/periodically scan the live feed to identify any presentvisual tags. The analytics server scans the visual tags present withinthe live feed received from the camera. The analytics server may alsoscan other live feeds received from other camera (e.g., camera placed onthe couch, such as at depicted in FIG. 2E). The analytics server thenqueries a data table to identify the corresponding accessory. If thevisual tag for a particular accessory is identified within the frame(e.g., the visual tag is present within the live feed of the couch), theanalytics server determines that the accessory is present within thepredetermined proximity to the radiotherapy machine/couch.

Additionally or alternatively, the analytics server may use beacontechnology to identify location of different accessories. Each accessorymay include a beacon receiver configured to receive a unique identifierof a beacon transmitter placed at different locations within thetreatment room (e.g., on the radiotherapy machine or in other corners ofthe room). The analytics server may use the unique identifier, signalstrength, and/or triangulation to identify the location of eachaccessory (e.g., beacon receiver placed on each accessory). In anon-limiting example, the analytics server receives three uniqueidentifiers and signal strengths from three different beacon receivers.The analytics server then queries a data table to identify an accessoryassociated with each beacon receiver (e.g., each beacon receive may alsohave an identifier that is unique to a particular accessory). Theanalytics server then identifies the location of each identifiedaccessory based on the signal strength received from each beaconreceiver.

At step 750, when the analytics server does not detect one or more ofthe one or more accessories in proximity to the radiotherapy machine orwhen one or more of the one or more accessories is not within apredetermined location, revising, by one or more servers, the graphicalindicator corresponding to that accessory. When the analytics serverdoes not detect the accessory in proximity to the radiotherapy machine,the analytics server may revise the graphical indicator on the GUIcorresponding to the accessory. If the analytics server determines thatthe necessary/needed accessory (identified in step 710) is not withinthe predetermined proximity to the radiotherapy machine, the analyticsserver may revise the graphical indicator associated with the accessory.The analytics server may revise the graphical indicator on the GUI, suchthat the technician or other end user operating the radiotherapy machineand/or viewing the page is notified that the accessory is missing.

Additionally, or alternatively, the analytics server may generate andtransmit a notification to one or more electronic devices describedherein (e.g., described in FIG. 1A). For instance, the analytics servermay notify the end user by displaying a prompt on the page displayed instep 720 or other pages (e.g., page on the console GUIs). In anotherexample, the analytics server may notify a second device (e.g.,physician or clinician computing device). The notification may bevisual, haptic, auditory, and the like. Therefore, even though aspectsof the method 700 are described in terms of visual notifications, theyare not limited to such embodiments.

Referring now to FIGS. 7B and 7C, non-limiting examples of the analyticsserver displaying and/or revising pages of the GUI based on necessaryaccessories are depicted. In one example, the analytics server mayinstruct a screen associated with a radiotherapy machine to display thepage depicted in FIG. 8 on a screen associated with a radiotherapymachine, such as on the gantry, on a screen of the radiotherapy room,and/or on a console or any other monitoring screen. Furthermore, asdescribed above, the analytics server may display the pages depictedherein in conjunction (e.g., as a part of a series) with otherstage-based pages.

As depicted in FIG. 7A, the analytics server may display a live feed ofa radiotherapy machine. For instance, the analytics server may receive alive feed from a camera placed on the couch and display a graphicalcomponent 769 corresponding to a live feed of the patient positioned onthe couch. The graphical component 769 may be an actual image (revisedin real time as the patient moves) and/or a two-dimensional orthree-dimensional representation (e.g., animation) representing thepatient.

The analytics server may also display patient information, such as thepatient's name or an identifier, date of treatment, and the like. Forinstance, the analytics server displays the patient's name in agraphical component 766. The analytics server may further displayvarious other treatment and/or radiotherapy machine attributes, such asdepicted in a graphical component 768.

The analytics server may use the methods and systems described herein toidentify a list of necessary accessories for the patient depicted in thegraphical component 766. As a result, the analytics server may display agraphical indicator 760-764 where each graphical indicator correspondsto one accessory needed for the patient. More specifically, theanalytics server identifies that the patient needs a breast board, 1 cmbolus, and a knee wedge. As a result, the analytics server may displaythe graphical indicators 760-764 respectively. Each indicator may alsoinclude a status indicator 760A-764A. Each status indicator maycorrespond to a status of each respective accessory. For instance, asdescribed above, the analytics server uses a variety of methods andsystems to identify whether an accessory is present within thepredetermined proximity to the radiotherapy machine (e.g., the couch).

The status indicator of each accessory may convey/identify whether theanalytics server has identified the accessory to be present within thepredetermined proximity. The status indicator may correspond todifferent colors, shapes, hatch patterns, words, or any other method ofindicating whether an accessory is present. In the depicted embodiment,the analytics server uses colors (e.g., orange) to identify that anaccessory is not present. For instance, the status indicator 760Aindicates that the breast board is not present within the predeterminedproximity to the couch (e.g., two feet or any other proximity set by thesystem administrator and/or the end user). In other embodiments, theanalytics server may display text indicating whether each accessory ispresent. In some embodiments, the analytics server may display aparticular shape indicating whether an accessory is present (e.g.,circle status indicator to identify presence and triangle to indicatemissing accessories). The analytics server may determine both proximityand/or position of the accessories relative to machine/couch and signalthe status accordingly.

Referring now to page depicted in FIG. 7C, the analytics server maydisplay similar features on the GUI as described in FIG. 7B. Forinstance, a graphical indicator 776 displays the patient's name and agraphical indicator 778 displays treatment and/or radiotherapyattributes associated with the patient's treatment. Moreover, the GUImay display a representation (or the actual image) of the patientpositioned on the couch. The GUI may display graphical components770-774 where each graphical component corresponds to an accessoryneeded for the patient's treatment. The GUI may display each indicatorin a different color, such that the color indicates whether theaccessory is present within the predetermined proximity to theradiotherapy machine. For instance, as depicted, the GUI displays thegraphical component 770 (bolus 1) and the graphical component 772 (bolus2) in orange to indicate that bolus 1 and bolus 2 are not present withinthe predetermined proximity.

Additionally, or alternatively, the GUI may display a status indicatoridentifying that an accessory identified within the pre-determinedproximity is the wrong accessory. As a result, the analytics server mayrevise the graphical and/or status indicator (in real time or near realtime) to identify that the wrong accessory is being used. For instance,the graphical indicator 774 in red may indicate that its correspondingaccessory is not within the list of accessories needed for the patient'streatment (e.g., retrieved from the RT file or otherwise received by theanalytics server).

The analytics server may continuously/periodically monitor locations ofone or more accessories and determine whether a needed accessory islocated within the predetermined proximity to the radiotherapy machine.Therefore, the analytics server may revise the status indicators in realtime or near real time to indicate their presence. For instance, whenthe technician places a required accessory on the couch, the analyticsserver may revise its status indicator in real time such that the statusindicator identifies that the required accessory is within thepredetermined proximity.

For instance, when the analytics server determines that bolus 1 islocated within the predetermined proximity, the analytics server mayrevise the status indicator of the graphical component 770 on the GUI,such as by changing the orange color to green or translucent. In anotherembodiment, when the technician moves the wrong accessory correspondingto the graphical indicator 774 away from the radiotherapy machine, theanalytics server may revise the graphical indicator 774 by removing it,changing its color, shape, or any other manner that is visuallydistinct.

In some configurations, the analytics server may not allow the end userto move to a subsequent stage until and unless all needed medicalaccessories are placed within the predetermined proximity. For instance,if the analytics server identifies that the patient needs a knee wedge,the analytics server may disable one or more graphical components withinthe depicted pages, such that the technician cannot move to a next pageuntil the analytics server identifies the knee wedge is within thepredetermined proximity.

Additionally, or alternatively, the analytics server may be programmed,such that it only displays accessories present within the predeterminedproximity. For instance, the analytics server may monitor location ofone or more accessories within the predetermined proximity and maydisplay on the GUI a graphical indicator for each accessory placedwithin the predetermined proximity. In some other embodiments, the GUImay display a translucent indicator corresponding to one or more neededaccessories. The analytics server may then change the status indicator(and/or change the color of each translucent indicator) based on whetherits corresponding accessory is within the predetermined proximity.Additionally, or alternatively, the analytics server may only displaythe graphical indicator for each missing and/or incorrect accessories.

Features on the GUI

FIG. 8 illustrates a schematic of a GUI 802 that is capable ofcommunicating with the analytics server and displaying variousinteractive pages that contain various graphical elements, such as thosepresented in FIGS. 7B and 7C. The GUI 802 presents a page 804 on adisplay 800.

The GUI 802 is presents information from the analytics server on thedisplay 800, such as a screen on a gantry (e.g., on a throat of thegantry as described in FIGS. 2A-2F), a console display, a mobile phone,monitor, or other computing device. The analytics server mayasynchronously or synchronously display the pages on one or more screensoutside the treatment room and on various devices using variousplatforms. At some time before the treatment begins (e.g., theradiotherapy machine begins treating the patient with radiation), theanalytics server may disable the screen.

The page presented by the analytics server may be a page associated withradiotherapy treatment of a patient (e.g., a person to be treated by theradiotherapy machine). Some of the pages presented by the analyticsserver may correspond to stage within a workflow (e.g., as discussed inFIGS. 4A-4P). The analytics server may display only relevant informationon each page. Relevant information, as used herein, may refer to asubset of all information used to treat the patient at a given stage inthe workflow. The relevant information may be consumed by the user whilethe user performs tasks at a given stage of workflow. The analyticsserver displays the relevant information for the current stage ofworkflow on a page. The analytics server may also display variousgraphical elements on the pages of the page. For example, graphicalelements on various pages may include progress indicators, treatmentrelated images, non-treatment related images, backgrounds, live feeds ofthe radiotherapy machine, and notes as discussed herein.

The GUI 802 allows transition of the page 804 to at least a second pageso that a user (e.g., technician) can navigate the GUI 802 and ensureproper configuration for treatment. The second page of the GUI 802presented by the analytics server may contain additional informationabout the first page, as described in FIG. 4E. For instance, one or moregraphical elements of the second page may relate to and/or containadditional information of one or more graphical elements on the firstpage. The progress indicator may indicate whether the page displayed bythe analytics server is associated with a stage of the workflow and/oris associated with supplemental information of a page in the workflow.Additionally, or alternatively, the progress indicator may indicatesucceeding and/or preceding stages in the workflow.

In this example, the page 804 has a graphical component for an alignmentangle 806 and a graphical component for an accessory 808. Thesegraphical components 806, 808 can be positioned on an edge of the page,in the middle of the page, or upon activating a button (e.g., clicking abutton or otherwise interacting with the button) on the page. Thegraphical components 806, 808 can include indicators and/or text toillustrate status, action items, alerts, issues, etc., associated withthe alignment angle or one or more accessories.

On the one or more pages of the GUI 802 presented by the analyticsserver, the alignment angle graphical component 806 indicates asatisfactory position for treatment. As discussed herein, thesatisfactory position for treatment, as determined by one or morepredetermined alignment positions allows the radiotherapy machine toradiate the positioned particular area of the body while minimizingradiation exposure to other parts of the body. The predeterminedalignment angle(s) may be determined by a user and/or systemadministrator.

In the event that the position of the patient is different from thesatisfactory position for treatment (e.g., the position of the patientis not within a predetermined margin of error), the analytics server mayvisually distinguish, using various graphical elements such as modelsand other graphical indicators as discussed herein, the position of thepatient from the satisfactory position for treatment. The analyticsserver visually distinguish the position of the patient from thesatisfactory position for treatment using colors, patterns, textures,shininess, opaqueness, and the like.

On the one or more pages of the GUI 802 presented by the analyticsserver, the accessory graphical component 808 can identify to a userwhether the analytics server has determined that the necessaryaccessories for the radiotherapy treatment of the patient are located.The analytics server may also use graphical indicators to indicateradiotherapy machine parameters and adjustments such that a patient maybecome aligned with satisfactory positions for treatment.

As discussed herein, the analytics server may use status indicators tovisually distinguish whether the analytics server has determined thatthe necessary accessories for radiotherapy treatment of the patient arelocated. For instance, various colors, shapes, borders and the like maydistinguish the analytics server displaying that an accessory is in aproper position or that an accessory is not within a predeterminedproximity.

Various features of one or more pages described herein are detailed withreference to FIGS. 4A-12B. For instance, visualization of the alignmentangle(s) and different non-limiting examples of revising the position ofthe patient based on the alignment angle(s) are described in FIGS.5A-5C. Moreover, visual representation of accessories (e.g., how theanalytics server identifies the needed accessories and how it visuallyindicates the presence/absence of each needed accessory) is detailed inFIGS. 7A-C.

Navigation Using Pendant

Referring now to FIG. 9 , a flowchart depicting operational stepsperformed by an analytics server is depicted, in accordance with anembodiment. The method 900 describes how a server, such as the analyticsserver described in FIG. 1A, may allow a user to navigate variousinteractive pages of a GUI configured to display various stages ofperforming radiotherapy on a patient. Even though the method 900 may bedescribed as being executed by the analytics server, the method 900 canbe executed by any server(s) and/or performed locally using acomputer/processor associated with a radiotherapy machine and/or aconsole (e.g., such as the radiotherapy machine and the console depictedin FIG. 1A). Other configurations of the method 900 may compriseadditional or alternative steps, or may omit and/or mix one or moresteps altogether.

At step 910, the analytics server may retrieve a RT file associated withone or more. RT file may be retrieved from one or more a medicaldatabases (such as the medical database in FIG. 1A), servers, files, andthe like. As described herein, the analytics server may retrieve varioustreatment information associated with the patient's treatment from avariety of data sources. For instance, the analytics server may retrievea file that may include all treatment information (e.g., treatmentattributes including type of treatment and field geometry, such asalignment angles, accessories, and other attributes). In someconfigurations, the analytics server may retrieve the data from multiplesources.

At step 920, in response to receiving a selection of a patient withinthe one or more patients, the analytics server may display on a screenassociated with a radiotherapy machine (e.g., a screen on a gantry ofthe radiotherapy machine), a series of consecutive pages. A first pagewithin the series of consecutive pages may include a first graphicalindicator corresponding to a first attribute associated withconfiguration of the radiotherapy machine and a second graphicalindicator corresponding to a second attribute associated with thepatient.

Steps 910 or 920 describe an embodiment where the analytics serverretrieves RT files associated with multiple patients and then receives aselection from an operator of the radiotherapy machine (e.g., technicianin the treatment room). Upon receiving the selection, the analyticsserver identifies treatment data (RT file(s)) associated with theselected patient and displays the GUIs described herein. Therefore, themethod 900 is specific to the patient who is being treated.

In response to receiving a selection of a patient from the one or morein the RT file, the GUI displays a page associated with the selectedpatient. The GUI may be a series of consecutive pages, wherein a firstpage within the series of consecutive pages comprises a first graphicalindicator corresponding to a first attribute associated withconfiguration of the radiotherapy machine and a second graphicalindicator corresponding to a second attribute associated with thepatient.

The response (e.g., displaying the pages) by the server may be generatedby a user input (e.g., an input from a pendant as discussed in FIGS.3A-3B), and the like. For instance, a user may select a patient to betreated using a page displayed by the analytics server. Additionally, oralternatively, the response by the server may be in response to a timingtrigger (e.g., the time at which the patient is expected to begin anappointment with the radiotherapy machine).

The analytics server may present for displaying (e.g., instruct adisplay screen associate with the radiotherapy to display) the page onthe display screen associated with of the radiotherapy machine (e.g.,the display positioned on the gantry as described in FIGS. 2A-2F). Thedisplay screen may be placed onto (other otherwise connected to) theradiotherapy machine itself, such as by placing the display screen onthe throat (or any other part) of the gantry. The display screen mayalso be placed in the treatment room (e.g., the same room as theradiotherapy machine). Various other display screens may display thepages displayed by the analytics server. For instance, display screensin rooms outside of the treatment room (such as a room monitoring thetreatment room) may display the pages displayed by the analytics server.Additionally, or alternatively, the page may be displayed on variousplatforms. For instance, a user may view the pages displayed by theanalytics server on the various platforms by executing an applicationsuch as a browser application. Therefore, the GUIs described herein arenot limited to being displayed on the display located on theradiotherapy machine or the console monitors.

Various pages associated with the method 900 and displayed by theanalytics server may be a part of a workflow-oriented series of pagesdescribed herein. Additionally, or alternatively, the various pagesassociated with the method 900 may be standalone pages that can beseparately displayed (e.g., not as a part of the workflow-orientedseries of pages). The workflow-oriented series of pages associated withthe method 900 can be modified (e.g., with respect to content, withrespect to order, with respect to the number of stages) by a systemadministrator and/or user.

The analytics server may display a room setup page on the GUI. Asdiscussed in greater detail in FIG. 4D, the room setup may include alive view of the couch, the setup notes, the patient information, therequired accessories, and the machine parameters.

The pages of GUIs described herein may be displayed on multiple screens(and on various platforms) in a synchronous or asynchronous manner. Forinstance, the analytics server may display the pages described herein onthe throat of the gantry, radiotherapy room screen, console monitors,and/or a physician device in a simultaneous or near simultaneous manner,such that one or more users can monitor the actions of the user in thetreatment room. For instance, the actions performed by a technician inthe treatment room may be monitored by another technician using theconsole monitors.

Additionally, or alternatively, the analytics server may receive one ormore inputs that may cause an alert and/or indicator on the pagedisplayed to the user in the treatment room. The alert and/or indicatormay be visual and/or audible. For instance, a user may notify the userin the treatment room that the user in the treatment room may be missingsomething (e.g., an accessory) and/or did not complete a task. Theanalytics server may also receive one or more inputs that have a neteffect of changing the displayed page in the treatment room. Forinstance, the displayed page may change to display a different page.

The analytics server presents for display a series of consecutive pagesonto the display screen. The series of consecutive pages may include afirst page including a first graphical indicator corresponding to afirst attribute associated with a configuration of the radiotherapymachine. The first attribute may include any data associated with theradiotherapy machine. The data associated with the radiotherapy machinemay include, but is not limited to, the radiotherapy machine alignmentparameters, software machine parameters, gantry position, couchposition, and the camera positions. The data associated with theradiotherapy machine may also include received inputs from the pendant,the console monitor, and the system administrator computer.

The first page may also include a second graphical indicatorcorresponding to a second attribute associated with the patient. Thesecond attribute may include any known parameter regarding the patientused for, but not limited to, the alignment of the patient, the currentsurface matching of the patient, and the position of the patient. Thesecond attribute may include data corresponding to aligning the patientwith a predetermined alignment angle.

At step 930, when the server receives an indication that a userinteracting with a pendant having a processor in communication with theserver has inputted a first input corresponding to a first directiontowards the first graphical indicator, the server causes the displayscreen to display a second page comprising data associated with thefirst attribute.

If the server receives an indication that a user interacting with apendant having a processor in communication with the server and theradiotherapy machine has inputted a first input corresponding to a firstdirection towards the first graphical indicator, displaying, on thegantry, a second page comprising data associated with the firstattribute. The second page may include alphanumerical values retrievedfrom the RT file. The alphanumerical values may correspond to aligningthe patient based on a predetermined alignment angle.

The analytics server may receive an indication that the user may beinteracting with a pendant (e.g., the pendant as depicted in FIGS.3A-3B). The user may indicate a desire to see more detailed informationregarding the first graphical indicator. As a result, the user maysubmit an input corresponding to a direction towards the first graphicalindicator. For instance, the user may interact with an input element ofthe pendant (e.g., interact with the track pad (e.g., swipe), interactwith the wheel, and/or interact with (e.g., click) a button in thedirection of the first graphical indicator using the pendant). As aresult, the analytics server may direct the user to a new page (referredto herein as the second page). The second page may include dataassociated with the first attribute. A non-limiting example of an inputin a first direction is illustrated in FIG. 4E.

As discussed in greater detail in FIG. 4E, the user may swipe in adirection (or input the direction using any other method, such as byclicking a button in the pendant). This causes the analytics server totransition to a new page (second page) that displays detailedinformation regarding the first indicator. For example, if the userswipes the touch pad of the pendant in a specific direction, theanalytics server may then display the setup information details.

FIGS. 4F-4G depicts an example of a second page. As described in moredetail in FIGS. 4F-4G, the displayed pages may provide additionalaccessory information for the user. The setup notes may include setupphotos, setup notes, and the accessories for the selected patient. Theanalytics server may display the pages depicted in FIGS. 4F-4G when theuser clicks (or other interacts with the GUIs) towards the graphicalindicator 430 depicted in FIG. 4D.

As discussed herein, the user may navigate each of the pages using thependant. The pendant may include a processor and may be communicativelycoupled with the radiotherapy machine and/or the analytics server. Theuser may input to the pendant the first input that indicates to theanalytics server that the user may be seeking additionalinformation/details. For instance, the user may press a left button onthe pendant, swipe left on the trackpad of the pendant, or the like. Inthe event that the analytics server receives an indication of the user'sinteraction, the analytics server may display the second page on thegantry.

Referring back to FIG. 9 , at step 940, when the analytics serverreceives an indication that a user interacting with the pendant hasinputted a second input corresponding to a second direction towards thesecond graphical indicator, the server causes the display screen todisplay a third page including data associated with the secondattribute.

If the server receives an indication that a user interacting with thependant has inputted a second input corresponding to a second directiontowards the second graphical indicator, displaying, by the server on thegantry, a third page comprising data associated with the secondattribute. The third page may include alphanumerical values retrievedfrom the RT file. The alphanumerical values may correspond to aligningthe patient based on a predetermined alignment angle.

The analytics server may receive an indication that the user may beinteracting with the pendant. The user may indicate a desire to see moredetailed information regarding the second graphical indicator. As aresult, the user may submit an input corresponding to a directiontowards the second graphical indicator. For instance, the user mayinteract with an input element of the pendant (e.g., interact with thetrack pad (e.g., swipe), interact with the wheel, and/or interact with(e.g., click) a button in the direction of the second graphicalindicator). As a result, the analytics server may direct the user to anew page (referred to herein as the third page). The third page mayinclude data associated with the second attribute. A non-limitingexample of an input in a second direction is illustrated in FIG. 4E.

As discussed in greater detail in FIG. 4E, the user may swipe in adirection. This causes the analytics server to display the respectivepage. For example, if the user swipes their finger from the actionbutton to the machine details, the analytics server may then display themachine details.

FIG. 4I depicts an example of the third page. As described in moredetail in FIG. 4I, the displayed page may provide additional setupinformation for the user such as setup notes and machine parameters. Theanalytics server may display the page 400 i depicted in FIG. 4I when theuser clicks (or otherwise interacts with the pendant) towards thegraphical indicator 428D depicted in FIG. 4D. In another non-limitingexample, when the user clicks towards the direction of the graphicalindicator 421 depicted in FIG. 4D, the GUI directs the user towards thepage 400 h depicted in FIG. 4H.

Additionally, or alternatively, the analytics server may display thethird page on the display screen in response to a user's second input(e.g., a “menu” button on the pendant and/or display). For instance, theanalytics server may display to the user the interactions that the usermust perform to receive additional information. For example, if the userpresses the menu button, the third page may display to the user thedifferent menu options available to the user. In some configurations, adesignated button may be customized to direct the user to the second orthird pages. For instance, a button on the pendant may be customized,such that when pressed, the analytics server directs the user to anotherpage displaying information that is more detailed.

For example, as described in FIG. 3B, the pendent may have a customizedhome button such that a user's interaction with the home button maynavigate the user to go to a home page. The home page may be the firstpage of the workflow. Additionally or alternatively, the home page maybe the first page of the stage of the workflow the user is currently in.Further, the pendent may have a customized return button (e.g., backbutton). The return button may cause the workflow to return back a step.For example, if the technician would like to return to a prior step ofthe workflow, the technician may press the return button. Further, thependent may have a customized safety button. The safety button mayprevent the accidental repositioning of the couch if the set of buttonsare unintentionally pressed by a user.

Console Monitors

Referring now to FIGS. 10A-10D, various embodiments describing theconsole monitor (such as the console monitors 150 depicted and describedin FIG. 1A) are provided. FIG. 10A, in conjunction with FIGS. 10B-D,illustrate various components of console system 1000 having two monitors1002 and/or 1004 used in a radiotherapy system 1006. The radiotherapysystem 1006 may be similar to the radiotherapy system depicted in FIG.1A. The console monitors 1002, 1004 may be positioned outside of thetreatment room, such as in a console room. The console monitors 1002,1004 allow a user (e.g., technician, doctor, nurse, or otherprofessional) to monitor a patient while the patient is receivingtreatment. Although the example embodiment shows console monitor 1002used for patient monitoring or other controls, other configurations mayallow patient monitoring or other controls using console monitor 1004 inaddition to or instead of console monitor 1002. Throughout thedisclosure, controls described as being utilized on one of the consolemonitors can be implemented on the other console monitor. Throughvarious pages of a GUI provided by the analytics server, the user candetermine whether the radiotherapy system 1006 has been set-up properly.The user can also view the current machine parameters of theradiotherapy system 1006. The user may be able to use the consolemonitors 1002, 1004 to control the radiotherapy system 1006. The consolemonitors may include a dedicated input element (e.g., keyboard 1038)that can control the radiotherapy system 1006.

The console monitors 1002, 1004 may include a processing unit and anon-transitory machine-readable storage medium. The processing unit mayinclude a processor with a computer-readable medium, such as a randomaccess memory coupled to the processor. The console monitors 1002, 1004may be executing algorithms or computer executable program instructions,which may be executed by a single processor or multiple processors in adistributed configuration. The console monitors 1002, 1004 may beconfigured to interact with one or more software modules of a same or adifferent type operating within the radiotherapy system 1006.

Non-limiting examples of the processor may include a microprocessor, anapplication specific integrated circuit, and a field programmable objectarray, among others. The console monitors 1002, 1004 may be capable ofexecuting data processing tasks, data analysis tasks, and valuationtasks. Non-limiting examples of the console monitors 1002, 1004 mayinclude a desktop computer, a server computer, a laptop computer, atablet computer, and the like. However, some embodiments may include aplurality of server computing devices capable of performing varioustasks described herein. The one or more processors may communicate withthe analytics server to display various pages described herein.

The console monitor 1002 may be in communication with a server 1030(e.g., such as the analytics server depicted in FIG. 1 ). Non-limitingexamples of 1002 may include a desktop monitor, a tablet, a televisionmonitor, and the like. In some configurations, the console monitor 1002may be a touch screen (e.g., touch sensitive).

The console monitor 1002 may be configured to display a first GUI 1012.The first display 1010 may display a live view of the radiotherapymachine using one or more of the cameras described herein (e.g., cameraplaced on the couch, gantry, or on the walls/ceiling of the treatmentroom). For instance, the GUI 1012 may include a live view of the patientresting on the couch (on first display 1010) that is received from acamera at an end of the couch of the radiotherapy machine. The GUI 1012may also include a secondary live view of the treatment room, asdepicted in the live view box 1014. Therefore, the GUI 1012 may be apicture-in-picture display of the treatment room. The live feed depictedin the live view box 1014 may also be received from any of the camerasdescribed herein.

The GUI 1012 may be customized by the operator. In some configurations,the operator may select a desired camera and the analytics server mayrevise the GUI 1012 such that the live feed corresponds to the cameraselected by the operator. In some embodiments, the picture-in-picturemay include two live feeds of the same camera.

The analytics server may display, on the console monitor 100, a livefeed of a first camera and a second camera from a set of cameras (e.g.,a first camera and second camera from a set of cameras as depicted inFIGS. 2E-2G). The analytics server may provide the live feed of thefirst camera and the second camera simultaneously (or nearsimultaneously) to the console monitor 1002. In a non-limiting example,the console monitor 1002 may display a live view of the couch (from anyof the cameras pointed towards the couch, such as a room camera) wherethe live feed is not cropped or otherwise manipulated. The consolemonitor 1002 may also display a second live feed derived from the samecamera. The second display may be manipulated (e.g., cropped), such thatthe second display highlights a particular portion of the image receivedfrom the camera.

In some configurations, the analytics server may perform the imagemanipulation (e.g., cropping) dynamically. For instance, the analyticsserver may crop the live feed received and automatically adjust thecropping box, such that the feed displayed on the console monitor 1002stays focused on a particular area (e.g., the patient's chest wall orthe patient's face).

The operator may also change the placement of the live view box 1014.For instance, the live view box may be displayed at any other locationwithin the console monitor 1002 (e.g., bottom left or top right). TheGUI 1012 may also include a motion monitoring indicator 1016 and a beamdelivery progress indicator 1018. The operator may also revise the typeand/or the placement of these indicators. For instance, a user maydisplay a “collision” or a “beam on” indicator instead of the motionmonitoring indicator 1016.

The GUI 1012 may be placed in a “locked” mode, such that the live viewof the patient and/or the radiotherapy machine within the treatment roomis always displayed. Therefore, the console system 1000 may be requiredto display a live feed of the radiotherapy machine regardless of theworkflow steps described herein. This safety feature allows the useroperating the console system 1000 to consistently monitor the treatmentroom on one monitor while progressing through the workflow describedherein on another monitor.

While the analytics server is displaying a live view of the patientand/or the treatment room on the GUI 1012, the analytics server maydisplay a series of workflow-oriented pages on the console monitor 1004(as depicted in FIGS. 11C-11M). The console monitor 1004 may be incommunication with a server (e.g., such as the analytics server depictedin FIG. 1A). Non-limiting examples of the console monitor 1004 mayinclude a desktop monitor, and the like. In some embodiments, the seconddisplay 1020 may be a touch screen (e.g., touch sensitive).

The console monitor 1004 may be configured to display a GUI 1020. TheGUI 1020 may display various pages associated with radiation treatment.For example, the GUI 1020 may be directed to the workflow-orientedseries of pages described herein. In another example, the GUI 1020 maydisplay an image of the radiotherapy machine during treatment.Additionally, or alternatively, the analytics server may display a livefeed of the radiotherapy machine (e.g., live feed of the couch with orwithout the patient) on the GUI 1020.

The GUI 1020 may display various graphical indicators, as depicted inFIG. 10B. For instance, the GUI 1020 may include a graphical indicatorthat represents the analytics server executing surface matching on thepatient resting on the couch. The graphical indicator may indicate thatthe surfaces are not matched as described herein.

In another example, the GUI 1020 may include graphical indicators thatare displayed by the analytics server to provide setup note information.For example, the setup note information may convey illustrative examplesof an accessory on a particular patient being setup for treatment.Additionally, or alternatively, setup note information may conveyillustrative examples of an accessory on a two-dimensional orthree-dimensional representation (e.g., animation) of a patient beingsetup for treatment. A non-limiting example of the second GUI isdepicted in FIG. 11D.

The GUI 1020 may include graphical indicators that describe the areas ofthe patient requiring treatment. A patient may have multiple areas ofthe body requiring treatment. In the event that multiple areas of thebody require treatment, the treatments may be performed consecutively. Anon-limiting example of the second GUI is depicted in FIG. 11C.

The GUI 1020 may include graphical indicators that indicate theradiotherapy machine parameters. The radiotherapy machine parameters mayindicate a satisfactory position of the gantry and/or couch fortreatment. A non-limiting example of a second page is depicted in FIG.11E-F.

In some configurations, the operator may customize the GUIs describedherein, such that the console monitor 1004 displays the live view of thetreatment room and the console monitor 1002 displays one or more pages,such as the workflow-oriented series of pages described herein.

As illustrated in FIG. 10D, the first monitor 1002 and the secondmonitor 1004 may be coupled to one another via a hinge 1024. The hinge1024 may be disposed at the bottom end of the first monitor 1002 and thetop end of the second monitor 1004. This configuration places the firstmonitor 1002 vertical to the second monitor 1004. In some embodiments,the hinge 1024 may be disposed at a first side of the first monitor 1002and a first side of the second monitor 1004 so that the first monitor1002 and the second monitor 1004 are disposed horizontally.

The hinge 1024 may include a first arm 1026 (e.g., extension). The firstarm 1026 may extend from the hinge 1024 to along the rear of the firstmonitor 1002. The hinge 1024 may be coupled to a first monitor center1028. The first monitor center 1028 may be disposed on and coupled tothe rear of the first monitor 1002. The first monitor center 1028 andthe first arm 1026 may co-facilitate the movement of the first monitor1002 during the rotation of the hinge 1024. In operation, if a useradjust the first monitor 1002 to raise the height from the console, thefirst monitor 1002 and the second monitor 1004 will actuate from thehinge to increase the angle between the monitors 1002, 1004 but keepsthem in a vertically-oriented position respective to each other.

The hinge 1024 may also include a second arm 1032 (e.g., extension). Thesecond arm 1032 may extend from the hinge 1024 to the rear of the secondmonitor 1004. The hinge 1024 may couple to a second monitor center 1034.The second monitor center 1034 may dispose on and coupled to the rear ofthe second monitor 1020. The second monitor center 1034 and the secondarm 1032 may co-facilitate the movement of the second monitor 1004during the rotation of the hinge 1024.

The hinge 1024 may also include a stand 1036 (e.g., support). The standprovides structural support to the hinge 1024 so that at different setpoints (e.g., stop point) of the hinge 1024, the first monitor 1002 andthe second monitor 1004 are provided support by the stand. In someembodiments, the stand 1036 incorporates linear actuators. In someembodiments, the hinge 1024 may include linear actuators to facilitatethe travel of the first monitor 1002 and the second monitor 1004. Inother embodiment, the stand 1036 may be coupled to pivoting members. Insome embodiments, the hinge 1024 may be hydraulically coupled to thestand 1036.

In some embodiments, the actuators may be linked to a user's logininformation, such that upon the user logging in, the actuatorautomatically adjusts itself based on the user's preferences.

The console monitors 1002, 1004 may also include a keyboard 1038(sometimes referred to as the “dedicated keyboard”). The keyboard 1038may be an auxiliary component. In some embodiments, the keyboard 1038may be integrated into the console monitors 1002, 1004. The keyboard1038 may also be coupled to either one of the monitors or the stand(actuator), such that the keyboard 1038 moves along with one/twomonitors and/or the actuator/stand of the console system 1000. Thekeyboard 1038 may be configured to control the radiotherapy machine(e.g., adjust machine parameters, move the couch/gantry, start/stop thetreatment/radiation).

Console GUI

FIG. 11A illustrates a flowchart depicting operational steps performedby a server, such as the analytics server described in FIG. 1A,displaying various interactive pages of a GUI configured to displayvarious stages of performing radiotherapy on a patient. Even though themethod 1100 a is described as being executed by the analytics server,the method 1100 a can be executed by any server(s) and/or performedlocally using a computer/processor associated with the radiotherapymachine and/or the console (as discussed in FIGS. 10A-10D). Otherconfigurations of the method 1100 a may comprise additional oralternative steps, or may omit and/or mix one or more steps altogether.

At step 1102, the analytics server may present a first page of a firstGUI associated with a radiotherapy machine. As discussed herein, theanalytics server may asynchronously or synchronously display the pageson one or more screens outside the treatment room (including on one ormore screens on a console as described in FIGS. 10A-10D), inside thetreatment room (including on the gantry) and on various devices usingvarious platforms. The first GUI presented by the analytics server onthe one or more screens on the console may coordinate with the secondGUI presented by the analytics server in a treatment room.

The first GUI presented by the analytics server may contain a pageassociated with radiotherapy treatment of a patient (e.g., a person tobe treated by the radiotherapy machine), as shown in 1102. Some of thepages on the pages of the first GUI presented by the analytics servermay correspond to different stages within a workflow (e.g., as discussedin FIGS. 4A-4P). Each page may contain a plurality of pages to progressa user (e.g., technician, doctor, nurse or other professional) throughone or more stages. There may be five predetermined stages. A userand/or system administrator may determine the number of stages and thecontent associated with each of the stages. One or more pages may beused to describe the workflow stages to treat a patient using aradiotherapy machine. As described herein, the workflow progress(presented by the analytics server using pages) describes the workperformed by a user to treat a patient using the radiotherapy machine.In an example, a first page (corresponding to a first page) may be afirst stage of the workflow. As discussed herein, the analytics servermay display only relevant information on each page. Relevantinformation, as used herein, may refer to a subset of all informationused to treat the patient relevant at a given stage in the workflow. Therelevant information is information that a user (e.g., a technician,nurse, doctor or other professional) consumes while viewing thedisplayed page.

The analytics server's presentation of the first GUI on the screentransitions from a first page (showing a first page) to a second page(showing a second page) based on an input received by the analyticsserver, as shown in step 1103. The analytics server may transitionbetween the pages displayed to the user in response to one or moretriggers. Triggers may include a user's interaction at the console GUI(e.g., FIGS. 4A-4P), a user's interaction with the dedicated keyboard(e.g., FIG. 10B), a user's one or more actions performed in thetreatment room (e.g., FIGS. 4A-4P), a user's interaction with thependent (e.g., FIG. 3B), or the analytics server determining acompletion of one or more tasks performed in the treatment room (e.g.,FIGS. 4A-4P).

As discussed herein, the second page may contain information belongingto a stage on the first page. For example, the second page may containadditional information about the stage on the first page. Additionally,or alternatively, the second page may not contain information associatedwith the stage on the first page. For example, the second page mayprogress to a subsequent stage.

The input received by the analytics server may be an input generated bya user using a console (e.g., console described in FIGS. 10A-10D) in adifferent location (e.g., a console room located away from the treatmentroom). The analytics server may use the input generated by the user fromthe different location to transition both the GUI displayed on theconsole and the GUI displayed in the treatment room. In the event theanalytics server is displaying the GUI on additional monitors, theanalytics server may use the input generated by the user from thedifferent location to transition the GUIs displayed on any additionalmonitors. Additionally, or alternatively, the analytics server may usethe input generated by the user in the different area to transition onlythe GUIs displayed on the screen of the console. For instance, the userin the different area may be viewing a different GUI than the user inthe treatment room. Additionally, or alternatively, in the event theconsole is displaying one or more GUIs on various screens, the inputgenerated by the user in the different area may transition one or moreof the GUIs displayed on the various screens.

In one example, a console room has a display, and a radiotherapy machinehas a display on a gantry. An analytics server presents a first GUI onthe console room display and presents a second GUI on the radiotherapymachine display. Each of the first and second GUIs can transitionbetween pages based upon the stages of treatment. In some instances,such as a transition to a next stage, as the second GUI changes on theradiotherapy machine display, the first GUI on the console room displaywill also change. An input to or an action affecting the second GUI(e.g., indicating that at least a predetermined portion of tasksassociated with a stage has been satisfied) may cause the second GUI totransition from a first page of a first stage to a second page of asecond stage, and the first GUI will also transition accordingly.

Additionally, or alternatively, as discussed herein, the analyticsserver may deny the user using the radiotherapy machine (e.g., the userin the treatment room) from transitioning to the second page from thefirst page in response to one or more inputs by a user (or systemadministrator, third party, supervisor, or the like) in the differentarea. The user in the different area may also effectively “pause” theworkflow progression in the treatment room by denying the user in thetreatment room from progressing to the second page. In some embodiments,the user may still navigate to, view, and/or edit the data in the otherpages but the progress for that page is paused. That is, the analyticsserver will not track the executed and/or completed steps for the secondpage. The duration of the “pause” of the workflow progression may be fora predetermine period of time. For instance, the analytics server may“pause” the workflow progression for 10 minutes. In the event the“pause” of the workflow progression is determined to be a predeterminedperiod of time, the user in the different area may “un-pause” the“paused” workflow progression by inputting one or more inputs to theanalytics server.

Additionally, or alternatively, the analytics server may transition to asecond page from the first page based on an input from the user in thedifferent area. For instance, even in the event that the analyticsserver determines that the predetermined portion of tasks have beencompleted (e.g., using, for instance, the flag threshold as discussed inFIGS. 4A-4P), the analytics server may not transition to the second pagefrom the first page unless the user in the different area confirms thatthe predetermined portion of tasks have been completed. The user in thedifferent area will hereinafter be called the user in the console room,but it should be appreciated that the user may not necessarily be in theconsole room (e.g., the user may be viewing one or more various screenssuch as the screens displayed by the analytics server on one or moreplatforms).

Additionally, or alternatively, the analytics server may transition froma first page to a second page in the event the screen displaying thepage in the treatment room transitions from the first page to the secondpage. The pages in the treatment room may be transitioned as discussedherein (e.g., as described in FIGS. 4A-4P).

Additionally, or alternatively, the analytics server may transition froma first page to a second page on one or more screens in the event theanalytics server, monitoring the treatment room, determines that apredetermined portion of tasks have been completed in the treatmentroom, as discussed herein (e.g., as described in FIGS. 4A-4P).

Additionally, or alternatively, the analytics server may transition froma first page to a second page on one or more screens in the event thatthe analytics server receives an input from a user (e.g., a user in thetreatment room). For instance, the user in the treatment room mayinteract with a page displayed by the analytics server on the screen ona radiotherapy machine.

FIG. 11B illustrates the five stages of workflow for a console to beperformed for a successful execution of treating a patient withradiation using a radiotherapy machine, in accordance with anembodiment. Although five stages are shown, it is intended that theworkflow can comprise any number of stages and/or sub-stages. The method1100 b describes the workflow stages of performing radiotherapy on apatient displayed by a server, such as the analytics server described inFIG. 1A. The workflow stages displayed by the analytics server aredisplayed on various interactive workflow-oriented series of pagesconfigured to display the various stages. Even though the method 1100 bis described as being executed by the analytics server, the method 1100b can be executed by any server(s) and/or performed locally using acomputer/processor associated with the console. Other configurations ofthe method 1100 b may comprise additional or alternative stages, or mayomit and/or mix one or more stages altogether. Further, each of the fivestages of workflow represented in method 1100 b may be standalone stagesdisplayed by the analytics server on standalone pages.

Referring to FIGS. 11C-11M, non-limiting examples of the analyticsserver displaying pages based on a user's progression through the stagesof the workflow are depicted. Even though FIGS. 11C-11M illustrate aprogression in sequential pages, in some configurations the analyticsserver may display the depicted pages in another order. Moreover, theanalytics server may not display one or more of the pages describedherein. The analytics server may display various combinations andconfigurations of the pages depicted herein.

The pages depicted in FIGS. 11C-11M illustrate one or more pagesdisplayed by the analytics server on a console (or other separatescreen). The analytics server may use the methods and systems describedherein to display workflow-oriented series of pages (e.g., pages 1100c-1100 m, in FIGS. 11C-11M respectively) such that a user progressesthrough the workflow to successfully treat a patient using aradiotherapy machine.

As discussed herein, the analytics server may generate, receive, and/orretrieve a representation of a patient on the couch of the radiotherapymachine, representations of the gantry, representations of the couch,and/or representations of patient accessories (e.g., FIGS. 4A-4P).Additionally, or alternatively, the analytics server may monitor thepatient on the couch of the radiotherapy machine, gantry, couch, patientaccessories and user in the treatment room. The analytics server maydisplay the generated, received, retrieved, and/or monitored informationregarding the patient, couch, gantry, and radiotherapy machine in thetreatment room on one or more pages displayed using one or more screens.

For example, the analytics server may be in communication with aplurality of cameras (e.g., camera at an end of the couch, gantrycamera, or other cameras places within the radiotherapy room and thelike) to capture images, continuous time series images, or streams ofvideo data from one or more perspectives of the patient, the accessoriesaround the patient, the couch, and/or the gantry (e.g., FIGS. 4A-4P).The analytics server may use any appropriate method of generating modelsor images to represent the patient on the couch of the radiotherapymachine, the couch, and/or the gantry. Additionally, or alternatively,the analytics server may use the live feed of data captured from theplurality of cameras from one or more perspectives as representations ofthe patient on the couch of the radiotherapy machine, the couch, and/orthe gantry.

At step 1104, the analytics server displays Stage One, which representsthe stage related to patient selection. Stage One of the consoleworkflow (e.g., step 1104 in FIG. 11B) may be similar in structure andoperation to Stage One of the treatment room workflow (e.g., step 410 inFIG. 4B). For instance, Stage One displayed by the analytics server onthe console room may contain the same information as Stage One displayedby the analytics server on a screen on the gantry.

In FIG. 11C, page 1100 c (Stage One, Patient Selection) displayed on aGUI by the analytics server may use the same (or similar) graphicalelements as discussed herein with respect to a GUI on a radiotherapymachine. For example, graphical elements displayed by the analyticsserver may include graphical indicators, status indicators, progressindicators, treatment related images, non-treatment related images,backgrounds, live feeds of the radiotherapy machine, and notes asdiscussed herein.

For instance, page 1100 c may include text 1110C conveying the date,text 1118C conveying the a patient time (e.g., the time of the patientscheduled for upcoming treatment, the time the patient is expected toarrive at the treatment area, the time the patient may begin treatment,the time the patient is expected to check-in, the wait time), text 1111Cemphasizing the patient schedule for upcoming treatment, graphicalelements 1112C, including both non-treatment related images and textthat convey PII, text 1113C conveying the current time, text 1114Cindicating one or more areas of the patient requiring treatment, text1116C conveying an alert, text 1117C conveying information about thepatient's upcoming medical appointments, as described similarly to thegraphical elements in FIGS. 4A-4P. Page 1100 c may also includeinteractive button 1115C that opens/displays the treatment informationand/or beings the treatment workflow associated with the emphasizedpatient scheduled for upcoming treatment in text 1111C.

In some embodiments, a user may interact with the page and/or aninteractive button on the page (not shown), triggering the analyticsserver to display one or more machine parameters in detail.

At step 1105, the analytics server displays Stage Two, which representsthe stage related to setting up the selected patient from step 1104 forradiotherapy treatment.

In FIG. 11D, page 1100 d (Stage Two, Setup) depicts summary informationthat may provide the user with a visual representation of what area ofthe patient is to be treated and a technique that is to be used to treatthe patient. The page 1100 d may use the same (or similar) graphicalelements as discussed herein. For example, graphical elements displayedby the analytics server may include graphical indicators, statusindicators, progress indicators, treatment related images, non-treatmentrelated images, backgrounds, live feeds of the radiotherapy machine, andnotes as discussed herein.

For instance, page 1100 d may include graphical elements 1112D,including both non-treatment related images and text that convey PII,text 1113D conveying the current time, text 1114D indicating one or moreareas of the patient requiring treatment, progress indicator 1122Dindicating the progress of the user in the treatment room (e.g.,highlighting the current stage and displaying the subsequent stages) andgraphical indicators 1124D (in conjunction with status indicators)conveying accessories located by the radiotherapy machine as describedsimilarly to the graphical elements in FIGS. 4A-4P.

The analytics server may display the model 1116D as a representation ofthe patient surface as known at the time of planning (or other time) andoverlay graphical indicator 1120D to indicate to the user what area ofthe patient is to be treated. Graphical indicator 1120D may indicate thetreatment beam projection overlaid on the model 1116D. The graphicalindicator 1120D may be extracted by the analytics server from usernotes, images during patient planning, and the like. The analyticsserver may also receive graphical indicator 1120D (e.g., as an inputfrom a user, from a database). As described herein, the representationof the patient may be a three-dimensional representation of the patientat the time of planning, a two-dimensional representation at the time ofplanning, and the like. In the event the patient has entered thetreatment room and positioned themselves on the couch, therepresentation of the patient may be a live feed view of the patientand/or a two-dimensional/three-dimensional representation of the patienton the couch.

Page 1100 d may also include interactive button 1115D that wheninteracted with, may result in a next page being displayed by theanalytics server. The analytics server may display pages in the consoleroom independently from the displayed pages in the treatment room. Forinstance, a user in the console room may view a different page from auser in the treatment room.

Additionally, or alternatively, the analytics server may display notes1126D that convey to the user (either in the treatment room or in theconsole room) information regarding setting up the patient on the couch.A user in the console room may view or edit the display notes 1126D inreal time (e.g., while the user in the treatment room is setting up thepatient). The analytics server may display the revised display notes1126D on one or more screens in various other areas (e.g., on a screenin the treatment room). Additionally, or alternatively, the user in theconsole room may edit the display notes 1126D before or after thetreatment scheduled with the patient.

In the event the user seeks addition information related to theinformation on the page displayed by the analytics server, the user maydirect the analytics server to transition to other pages using variousinputs. For instance, the user may interact with the console to generateinputs provided to the analytics server. An example of the types ofadditional information that the analytics server may provide based onthe user input is displayed in example 1100N of FIG. 11N. Additionally,or alternatively, as discussed herein, the analytics server may displayexample 1100N as a page on the console in response to a user input(e.g., a “menu” button on the console).

As discussed herein, for instance, similar to the inputs used in example400 e in FIG. 4E, the user may input the response 1190N to indicate tothe analytics server that the user is seeking additional setupinformation details, the user may input the response 1191N to indicateto the analytics server that the user is seeking to perform an action,the user may input the response 1194N to indicate to the analyticsserver that the user is seeking additional patient information details,and the user may input the response 1192N to indicate to the analyticsserver that the user is seeking additional machine details.

Referring now to FIG. 11E the analytics server may display additionalsetup information based on an input 1190N as shown in FIG. 11N.Additionally, or alternatively, the analytics server may display otherinformation supplemental information related to the current stage of theworkflow. For example, during the imaging stage of the workflow (StageThree), in response to receiving input 1190N, the analytics server maydisplay image acquisition settings. Similarly, during the treatmentstage of the workflow (Stage Five), in response to receiving input1190N, the analytics server may display treatment details. As discussedherein, the setup information on page 1100 e may not be mandatory withinthe series of page. That is, the user may never view page 1100 e and theanalytics server may not display page 1100 e unless and until requiredby the user (e.g., by an input). The page 1100 e may use the same (orsimilar) graphical elements as discussed herein. For example, graphicalelements displayed by the analytics server may include graphicalindicators, status indicators, progress indicators, treatment relatedimages, non-treatment related images, backgrounds, live feeds of theradiotherapy machine, and notes as discussed herein

For instance, page 1100 e may include graphical elements 1112E,including both non-treatment related images and text that convey PII,text 1113E conveying the current time, text 1114E indicating one or moreareas of the patient requiring treatment, progress indicator 1122Eindicating the progress of the user in the treatment room (e.g.,highlighting the current stage and displaying the subsequent stages),display notes 1126E providing setup note information, graphicalindicators 1124E (in conjunction with status indicators) conveyingaccessories located by the radiotherapy machine, and treatment relatedimages 1130E may be to clarify the display notes 452, as similarlydescribed similarly to the graphical elements in FIGS. 4A-4P.

Referring now to FIGS. 11F-11G, the analytics server may displayadditional information based on an input 1192N as shown in FIG. 11N. Asdiscussed herein, the setup information on pages 1100 f-1100 g may notbe mandatory within the series of pages. That is, the user may neverview pages 1100 f-1100 g and the analytics server may not display pages1100 f-1100 g unless and until required by the user (e.g., by an input).The pages 1100 f-1100 g may use the same (or similar) graphical elementsas discussed herein. For example, graphical elements displayed by theanalytics server may include graphical indicators, status indicators,progress indicators, treatment related images, non-treatment relatedimages, backgrounds, live feeds of the radiotherapy machine, and notesas discussed herein.

For instance, page 1100 f may include graphical elements 1145Fdisplaying a three-dimensional representation (e.g., animation)representing the radiotherapy machine and/or patient, graphicalindicator 1147F (in conjunction with status indicators) representingmore than one safety feature associated with the treatment room and/orconsole room, graphical indicator 1140F indicating the projected beamshape from the collimator and/or the type of beam, text 1141F conveyingsoftware machine parameters/accessories, text 1146F conveying hardwareaccessories, graphical indicators 1144F indicating the radiotherapymachine parameters (including the position of the couch in the treatmentroom compared to a predetermined satisfactory position for treatment ofthe couch and one or more suggested adjustments based on thecomparison), interactive button 1143F initiating a dry run (either aphysical dry run or a virtual dry run as discussed herein), andinteractive button 1142F initiating one or more preset positions of thecouch and/or gantry, as described similarly to the graphical elements inFIGS. 4A-4P. Additionally, or alternatively, the analytics server maydisplay a representation of the patient (e.g.,two-dimensional/three-dimensional images of the patient and/or thepatient and the couch).

Similarly, page 1100 g may include graphical elements 1145G (analternate representation of 1145F) displaying a three-dimensionalrepresentation (e.g., animation) representing the radiotherapy machineand/or patient, graphical indicator 1147G (in conjunction with statusindicators) representing more than one safety feature associated withthe treatment room and/or console room, graphical indicator 1140G (analternate representation of 1140F) indicating the projected beam spreadfrom the collimator and/or the type of beam, text 1146G (an alternaterepresentation of 1146F) conveying hardware accessories, graphicalindicators 1144G (an alternate representation of 1145F) indicating theradiotherapy machine parameters (including the position of the couch inthe treatment room compared to a satisfactory position for treatment ofthe couch and one or more suggested adjustments based on thecomparison), and interactive button 1142G initiating one or more presetpositions of the couch and/or gantry, as described similarly to thegraphical elements in FIGS. 4A-4P.

At step 1106, the analytics server displays Stage Three, whichrepresents the stage related to imaging the patient based on the patientin a position for treatment from step 1105. Stage Three may includeimage acquisition (e.g., pages 1100 h, 1100 i, 1100 k displayed in FIGS.11H, 11I, 11K) and image matching (e.g., page 1100 j displayed in FIG.11J). The image matching may be similar in structure and operation to aprocedure for determining whether a patient's internal organs areproperly aligned for treatment (e.g., FIGS. 12A-12B).

Pages 1100 h-1100 k (Stage Three, Image) displayed in FIGS. 11H-11Killustrate the pages associated with preparing to capture and capturingan image of the patient. For instance, the analytics server may prepareto capture an x-ray image, a CT scan, a four-dimensional CT scan,fluoroscopy images and the like. The pages 1100 h-1100 k may use thesame (or similar) graphical elements as discussed herein. For example,graphical elements displayed by the analytics server may includegraphical indicators, status indicators, progress indicators, treatmentrelated images, non-treatment related images, backgrounds, live feeds ofthe radiotherapy machine, and notes as discussed herein.

For instance, page 1100 h may include graphical elements 1112H,including both non-treatment related images and text that convey PII,text 1113E conveying the current time, text 1114H indicating one or moreareas of the patient requiring treatment, progress indicator 1122Hindicating the progress of the user in the treatment room (e.g.,highlighting the current stage and displaying the succeeding/precedingstages), 1145H displaying a three-dimensional representation (e.g.,animation) representing the radiotherapy machine, graphical indicator1147H (in conjunction with status indicators) representing more than onesafety feature associated with the treatment room and/or console room,graphical indicator 1140H indicating the projected beam spread from thecollimator and/or the type of beam, text 1141H conveying softwaremachine parameters and/or accessories, text 1146H conveying hardwareaccessories, graphical indicators 1144H indicating the radiotherapymachine parameters (including the position of the gantry and/or couch inthe treatment room compared to a satisfactory position for treatment ofthe gantry and/or couch and one or more suggested adjustments based onthe comparison), interactive button 1143H initiating a dry run (either aphysical dry run or a virtual dry run as discussed herein), andinteractive button 1142H initiating one or more preset positions of thecouch and/or gantry, as described similarly to the graphical elements inFIGS. 4A-4P.

Additionally, or alternatively, the analytics server may display text1150H indicating one or imaging techniques. For instance, cone-beamcomputed tomography (CBCT), may be employed by the radiotherapy machineto capture images of the patient. A user may select an imaging techniquefor the patient. Additionally, or alternatively, the imaging techniquemay be predetermined by a user and/or system administrator. Theanalytics server may also display graphical indicator 1153H indicating atype of fan scan. For instance, half fan or full fan scan types may beemployed by the radiotherapy machine. A user may select the fan type forthe patient. Additionally, or alternatively, the fan type may bepredetermined by a user and/or system administrator. As shown, the typeof fan is indicated using the indicator itself. For instance, in theevent a half fan was to be employed by the radiotherapy machine, thegraphical indicator 1153H may be a half-circle around a representationof the patient.

Text 1154H may convey an area of the patient's body (e.g., using arepresentation of the patient such as a live view feed and/or athree-dimensional animation) to be captured using the imaging technique.Text 1151 may convey the size of the patient. A user may select and/orinput the size of the patient to the analytics server. The analyticsserver may, based on the received size of the patient, determine variousimaging parameters (for instance, the type of fan as shown in graphicalindicator 1153H). The analytics server may receive a mapping of variouspatient sizes and various patient parameters. A user and/or systemadministrator may generate the map mapping the patient sizes to thepatient parameters.

Similarly, page 1100 i may include graphical elements graphical elements1112I, including both non-treatment related images and text that conveyPII, text 1113I conveying the current time, text 1114I indicating one ormore areas of the patient requiring treatment, progress indicator 1122Iindicating the progress of the user in the treatment room (e.g.,highlighting the current stage and displaying the succeeding/precedingstages), 1145I (an alternate representation of 1145H) displaying athree-dimensional representation (e.g., animation) representing theradiotherapy machine, graphical indicator 1147I (in conjunction withstatus indicators) representing more than one safety feature associatedwith the treatment room and/or console room, graphical indicator 1140I(an alternate representation of 1140H) indicating the projected beamspread from the collimator and/or the type of beam, text 1146I (analternate representation of 1146H) conveying hardware accessories,graphical indicators 1144I (an alternate representation of 1145H)indicating the radiotherapy machine parameters (including the positionof the gantry and/or couch in the treatment room compared to asatisfactory position for treatment of the gantry and/or couch and oneor more suggested adjustments based on the comparison), and interactivebutton 1142I initiating one or more preset positions of the couch and/organtry, as described similarly to the graphical elements in FIGS. 4A-4P.

Additionally, or alternatively, the analytics server may display text1158I to convey an imaging schedule for the patient. For instance,various days of the week may be associated with various imagingtechniques. It may be beneficial to schedule the imaging techniquesbecause it may be beneficial to keep track of and/or record thepatient's radiation intake (for instance, including the radiation thepatient receives as part of the imaging performed during the treatmentsetup) As shown, Monday is mapped to CBCT imaging, Tuesday is mapped tokilo voltage (kv) imaging, Wednesday is mapped to CBCT imaging, Thursdayis mapped to kv and Friday is mapped to CBCT imaging. A user maydetermine the imaging schedule. The imaging schedule may vary from weekto week.

Graphical indicator 1153I may be an alternate embodiment of graphicalindicator 1153H. Graphical indicator 1153I may indicate the type of fan.The selected fan type may appear visually distinguished from the one ormore other fan types. As disclosed herein, visually distinguished mayinclude identifying graphical indicator 1153I using a color, texture,shine, opacity, pattern, and the like. As shown, a full fan is selectedfor imaging the patient. Graphical indicator 1151I be an alternateembodiment of text 1151H. Graphical indicator 1153I may be used by auser to select the size of the patient. As shown, the user may slide ascale based on the appearance of the patient. As discussed herein, theanalytics server may modify the imaging parameters based on the selectedsize of the patient. Additionally, or alternatively, a user may set theimaging parameters in addition to selecting the size of the patient.Text 1154I be an alternate embodiment of text 1154H. Text 1154I mayconvey an area of the patient's body to be captured using the imagingtechnique.

Additionally, or alternatively, the analytics server may display onpages 1100 h-1100 i a planned image acquisition. The analytics servermay also overlay the image acquisition on the representation of thepatient, a topogram, and the like.

Page 1100 j may convey the imaging information received by the analyticsserver according to one or more appropriate methods of imaging internalorgans (e.g., x-ray, CT scan, and the like). For instance, page 1100 jmay include graphical elements 1112J, including both non-treatmentrelated images, treatment related images, and text that convey PII, text1113J conveying the current time, text 1114J indicating one or moreareas of the patient requiring treatment, treatment related image 1161J,1165J and 1166J displaying and overlaying one or more instances ofreference images and acquired images of a target organ from differentangles, graphical indicators 1167J, 1168J, and 1169J characterizinginternal organ misalignment in different axes and directions, graphicalindicators, graphical indicators 1176J, 1175J, 1174J, 1173J and 1172Jdisplaying various tools that a user may interact with to adjust,evaluate, and align the image of the target organ, interactive button1171J to retake an image, and interactive button 1170J accepting analignment displayed by the analytics server, as described similarly tothe graphical elements in FIGS. 12A-12B. Page 1100 k may be an alternateembodiment of page 1100 i. For instance page 1100 k may includegraphical elements graphical elements 1112K, including bothnon-treatment related images and text that convey PII, text 1113Kconveying the current time, text 1114K indicating one or more areas ofthe patient requiring treatment, progress indicator 1122K indicating theprogress of the user in the treatment room (e.g., highlighting thecurrent stage and displaying the succeeding/preceding stages), 1145K (analternate representation of 1145I) displaying a three-dimensionalrepresentation (e.g., animation) representing the radiotherapy machine,graphical indicator 1147K (in conjunction with status indicators)representing more than one safety feature associated with the treatmentroom and/or console room, graphical indicator 1140K (an alternaterepresentation of 1140I) indicating the projected beam spread from thecollimator and/or the type of beam, text 1146K (an alternaterepresentation of 1146I) conveying hardware accessories, graphicalindicators 1144K (an alternate representation of 1145I) indicating theradiotherapy machine parameters (including the position of the gantryand/or couch in the treatment room compared to a satisfactory positionfor treatment of the gantry and/or couch and one or more suggestedadjustments based on the comparison), and interactive button 1142Kinitiating one or more preset positions of the couch and/or gantry, asdescribed similarly to the graphical elements in FIGS. 4A-4P.

Additionally, or alternatively, the analytics server may display thegraphical indicators 1177K indicating a schedule of treatment. Eachindicator may have a corresponding text that identifies different fieldgeometry necessary to conduct the patient's treatment. In someembodiment, the patient's treatment may be performed in differentsegments where each segment requires different treatment attributes(e.g., alignment angles or field geometry). Each indicator within thegraphical indicators 1177K may correspond to each segment of thepatient's treatment. For instance, text 1177K may include the area ofthe body to be treated, the treatment type used, the treatment attribute(e.g., intensity), the gantry and/or couch positions for satisfactoryimages, and the like. For instance, 1177K may include text 1182Kindicating a first field geometry of the patient's treatment and itscorresponding attribute (e.g., treatment data).

The analytics server may also display other field geometries (e.g.,1178K and 1179K). As depicted, when the end user (medical professional)selects a particular field geometry or treatment segment, the analyticsserver may dynamically revise the 1100 k and display data correspondingto that particular field geometry. For instance, as depicted, themedical professional has selected the text 1182K and the other featuresdescribed within the GUI 1100 k may correspond to the text 1182K.

At step 1107, the analytics server displays Stage Four, which representsthe stage related to treatment (e.g., when the radiotherapy machine isactively radiating target areas of the patient). The user may monitorthe patient by the analytics server capturing data from one or morecameras in the treatment room (e.g., as described in FIGS. 2A-2F) anddisplaying a form of the captured data on one or more screens on theconsole. At any moment during treatment, a user may pause treatmentusing, for example, the dedicated keyboard. In response to receiving aninput to pause the treatment, the analytics server may turn off theradiotherapy machine such that the radiotherapy machine is not activelyradiating target areas of the patient.

Page 1100 l (Stage Four, Treat) displayed in FIG. 11L illustrates thepage associated with treatment. The page 1100 l may use the same (orsimilar) graphical elements as discussed herein. For example, graphicalelements displayed by the analytics server may include graphicalindicators, status indicators, progress indicators, treatment relatedimages, non-treatment related images, backgrounds, live feeds of theradiotherapy machine, and notes as discussed herein

For instance, page 1100 l may include graphical elements 1112L,including both non-treatment related images and text that convey PII,text 1113L conveying the current time, and the text 1114L indicating oneor more areas of the patient requiring treatment. The page 1100 l mayalso include the progress indicator 1122L indicating the progress of theuser in the treatment room (e.g., highlighting the current stage anddisplaying the succeeding/preceding stages), 1145L displaying athree-dimensional representation (e.g., animation) representing theradiotherapy machine, and the graphical indicator 1147L (in conjunctionwith status indicators) representing more than one safety featureassociated with the treatment room and/or console room. The page 1100 lmay also include the graphical indicator 1140L indicating the projectedbeam spread from the collimator and/or the type of beam. The page 1100 lmay also include accessory information (11140L).

The page 1100 l may also include the graphical indicator 1140Lindicating the projected beam spread from the collimator and/or the typeof the beam being used. “Beam spread,” as used herein may refer to anycomplete irradiated area outline. The shape depicted in the graphicalindicator 1140L (and similar indicators, such as 1140G, 1140H, 1140I,and 1140K) may correspond to an opening of the collimator that forms thebeam/radiation used for the patient's treatment. The opening (e.g.,sometimes referred to as the “jaw opening”) may be adjusted by themedical professional depending on the target organ (e.g., size of thetumor) and the shape depicted in the graphical indicator 1140L maycorrespond to the shape of the opening of the collimator. The medicalprofessional may use the graphical indicator to monitor the jaw openingshape and determine whether the shape of the jaw opening is correct(e.g., matches pre-determined attributes of the patient's treatment).

The page 1100 l may also include text 1141L conveying software machineparameters, text 1146L conveying hardware accessories, graphicalindicators 1144L indicating the radiotherapy machine parameters(including the position of the gantry and/or couch in the treatment roomcompared to a satisfactory position for treatment of the gantry and/orcouch and one or more suggested adjustments based on the comparison),interactive button 1143L initiating a dry run (either a physical dry runor a virtual dry run as discussed herein), and interactive button 1142Linitiating one or more preset positions of the couch and/or gantry, asdescribed similarly to the graphical elements in FIGS. 4A-4P.

Additionally, or alternatively, the analytics server may display text1180L conveying various one or more labeled fields of radiation employedby the radiotherapy machine during treatment. Text 1180L mayadditionally, or alternatively convey the intensity of the radiation,the gantry position, and the couch position. Text 1181L may emphasizethe field of radiation that may be actively employed to treat thepatient. Text 1181L may be visually distinct (e.g., highlighted) fromthe text 1180L to better to convey to a user the radiation that isactively treating the patient. As shown, the MU counter indicates theradiation treating the patient.

At step 1108, the analytics server displays Stage Five, which representsthe stage related to unloading the patient from the radiotherapymachine. Stage Five of the console workflow (e.g., step 1108 in FIG.11B) may be similar in structure and operation to Stage Five of thetreatment room workflow (e.g., step 419 in FIG. 4B).

Page 1100 m (Stage Five, Unload, as depicted by “unload” graphicalelement 1112M) displayed in FIG. 11M illustrates the page associatedwith unloading the patient. The page 1100 m may use the same (orsimilar) graphical elements as discussed herein. For example, graphicalelements displayed by the analytics server may include graphicalindicators, status indicators, progress indicators, treatment relatedimages, non-treatment related images, backgrounds, live feeds of theradiotherapy machine, and notes as discussed herein

For instance, page 1100 m may include text 1114M indicating one or moreareas of the patient requiring treatment, progress indicator 1122Mindicating the progress of the user in the treatment room (e.g.,highlighting the current step and displaying the previous steps) text1113M conveying the current time, and text 1110M conveying the date. Thepage 1100 m may also include the graphical indicator 1185M conveying thenumber of remaining radiotherapy treatments for one or more diagnosedareas of the body, and text 1186M conveying information about thepatient's upcoming medical appointments, as described similarly to thegraphical elements in FIGS. 4A-4P.

Additionally, or alternatively, the analytics server may display text1187M displaying billing information. For instance, the analytics servermay record the occurrence of several predetermined billing items anddisplay on page 1100 m the recorded billing items. For example, in theevent the analytics server captures an image of the patient using theimager, the analytics server may raise a flag associated with theimages. Upon completion of the treatment of the patient, the analyticsserver may tally the raised flags associated with images.

Additionally, or alternatively, the billing information may bepredetermined by a user and/or system administrator. For instance, auser may determine that two medical images will be captured throughoutthe scheduled treatment of the patient. The billing information mayinclude bills that have been accumulated during the recently completed(scheduled) radiotherapy treatment. Additionally, or alternatively, thebilling information may include bills that have been unpaid fromprevious one or more radiotherapy treatment sessions using radiotherapymachines. The billing information may include a number of imagescaptured, a number of treatments performed, the dates of the imagescaptures, the dates of the treatments performed, the cost of the imagescaptured, the cost of the treatments performed, a total cost, and thelike.

Additionally, or alternatively, the analytics server may displayradiotherapy machine parameters (e.g., the position of the couch),machine alignment parameters (e.g., position of the gantry and/orcollimator), and the like.

Alignment Page

As discussed above, the analytics server may identify one or morealignment attributes (e.g., alignment angles, dimensions, magnitudes,and/or surfaces for the patient) associated with the patient and thepatient's treatment. The alignment angles may indicate the patient'soptimum alignment/position on the couch, such that the effects of theradiotherapy machine (e.g., radiation emitted from the gantry) isoptimized. Using the alignment information provided by the analyticsserver, such as by displaying on the workflow-oriented series of pagesdescribed herein, the technician may align the patient's body on thecouch. However, the alignment angles only indicate an optimum alignmentangle for the patient's extremities and not interior organs. Forinstance, the alignment angle may indicate that the patient's arm mustbe moved to the left by a predetermined amount/magnitude in a particulardirection (e.g., angle). However, the alignment angles do not identify,and the technician may be unable to determine whether the patient'starget organs receiving the radiations are positioned to receive optimaltreatment. To rectify this problem, the analytics server may execute themethod 1200 and display on the GUI a page 1240, as depicted in FIGS.12A-B.

The method 1200 is not limited to identifying internal positioning oftarget organs. The method 1200 may also be applicable to mutual positionof the target organ and the other organs (sometimes referred to asorgans at risk or OARs). The organs at risk may be organs near thetarget organ that may inevitably receive radiation when the targetorgans receives radiation. Using the method 1200 and the GUIs describedherein, the user may evaluate how the organs at risk are positioned,such that these organs at risk receive minimal radiation during thepatient's treatment. In a non-limiting example, the method 1200 and theGUIs described herein can be used, such that the patient is realignedbased on the alignment of his/her organs at risk that are near his/hertarget organ. Therefore, the method 1200 is applicable to any internaltarget of the patient (e.g., target organ and other targets).

As used herein, the method 1200 and the page 1240 are described in thecontext of analyzing and displaying images. It is intended that imagesincludes any medical images received that represents the patient'sorgans using any medical imaging techniques and protocols, such asx-ray, CT scan, 4D CT scan, fluoroscopy imaging, ultrasound, and thelike.

The page 1240 may be a part of a stage-by-stage or workflow-orientedseries of pages. For instance, the analytics server may display the page1240 as a part of the workflow-oriented series of pages describedherein. In a non-limiting example, the analytics server may display thepage 1240 after the patient's body has been aligned using the alignmentangles (e.g., set up stage), such that a technician or any other medicalprofessional operating the console monitors may determine whether thepatient's internal organs are properly aligned for treatment. That is,the analytics server may compare the presentation of the target organ(e.g., image of the target organ) with optimal treatment orientationdetermined by other medical professionals (e.g., treating oncologist).

In other non-limiting examples, the page 1240 may be displayed after thetechnician has completed the workflow and before the patient's treatmentis commenced. For instance, a technician may use the workflow-orientedseries of pages described herein (displayed in the treatment room) andmay leave the treatment room before the radiotherapy machine startstreatment. However, before the treatment has begun, the technician (oranother medical professional) operating the console monitors placed in adifferent room may be required to confirm the patient's alignment.Therefore, the console monitors may display the page 1240 and thetechnician or the other medical professional may confirm that thepatient is aligned properly or delay the treatment to realign thepatient. When the page 1240 is displayed as a part of aworkflow-oriented series of pages, the workflow may not proceed to asubsequent stage (e.g., radiation therapy) unless the patient's internalorgans (target organ and/or OARs) are aligned within an acceptabletolerance (error threshold).

Due to the hazardous nature of medical imaging, the analytics server mayensure that the imager of the radiotherapy machine does not operatewhile the technician is still in the treatment room. Therefore, thedisplay of the page 1240 may be delayed, such that the technician hasleft the treatment room and the image can operate, at which time theanalytics server received the image from the imager and displays thepage 1240.

In some embodiments, the page 1240 may be displayed on one or both ofthe console monitors as a standalone page. For instance, the page 1240may not be a part of the workflow-oriented series of pages. Forinstance, a medical professional operating the console monitor, screenof the radiotherapy machine, or any other electronic device configuredto display the pages described herein (e.g., physician device or anadministrative device) may view the page 1240 to confirm that thepatient's internal organs are aligned properly. Medical professionalsmay access and view the page 1240 any time before the treatment hasbegun.

Additionally, or alternatively, the analytics server may capture imagesof the target organ and/or the organs at risk during the treatment orduring any period of the workflow described herein. These capturedimages may be subsequently reviewed by other medical professionals afterthe treatment of the patient.

Referring now to FIG. 12A, at step 1210, the analytics server mayretrieve, from a radiotherapy file of a patient, a first image of aninternal target of the patient aligned in accordance with one or moretreatment attributes. The analytics server may retrieve a RT file of thepatient that includes a first image of a target organ aligned inaccordance with one or more treatment attributes. As discussed herein,RT file may include various treatment attributes including machineattributes and patient alignments to provide an optimum radiotherapytreatment to the patient. Among other things described herein, the RTfile may include various alignment data indicating orientationattributes of a target organ (e.g., the organ receiving treatment) ororgans at risk (OARs). The RT file may also include an image of thetarget organ properly aligned to receive treatment.

In some embodiments, the analytics server may retrieve alignment datafrom other electronic data sources. For instance, the analytics servermay query one or more databases and/or electronic devices (e.g.,physician electronic device) to identify one or more alignmentattributes/angles. In some configurations, the RT file may not includean image. Therefore, the analytics server either may retrieve the imagefrom a different data source or may execute a protocol that generates animage resembling an image of the target organ aligned properly fortreatment.

At step 1220, the analytics server may receive a second image of theinternal target of the patient on a couch of a radiotherapy machine. Theanalytics server may then overlay, on a first page of the plurality ofpages, the first image and the second image, wherein the first pagedisplays a direction to position the internal target in the second imageto align with the internal target in the first image. Moreover, when thewhen the internal target is aligned, presenting, by the server, a secondpage of the plurality of pages corresponding to a subsequent stage ofthe radiotherapy treatment for the patient.

The analytics server may present a page comprising the first image, andan overlay displayed on the first image. The overlay may comprise asecond image (or a series/sequence of images, such as fluoroscopy,triggered imaging, and/or 4DCT) of the patient placed on the couch of aradiotherapy machine, the second image comprising the patient's targetorgan and/or OARs. The analytics server may display a page that includesthe first image of the patient's target organ overlaid by a second imagedisplaying the patient's target organ as currently positioned on thecouch. The technician or any other medical professional operating andviewing the page may use the two images to identify any discrepancies.For instance, the technician may visually inspect misalignments (e.g.,alignment differences) between the patient's internal organ at itscurrent position and the patient's internal organ as required by thetreating physician.

As discussed above, the GUIs described herein are not limited todisplaying target organs. For instance, in alternative embodiments, theanalytics server may display other organs (e.g., organs at risk) inaddition to or instead of the target organ.

Referring to FIG. 12B, the analytics server may display a GUI havingpage 1240. The page 1240 may include various graphical indicators andfeatures each interactive and configured to allow the user to customizethe page 1240. As described above, the analytics server may visuallyrepresent misalignments of the patient's interior organs such that thesemisalignments are easily identifiable to the technician or any othermedical professional viewing the page 1240. The page 1240 may includethe graphical indicator 1258 displaying treatment regions and/or organsassociated with the patient's treatment. If the patient is receivingtreatment on more than one treatment sites, the analytics server maydisplay the toggle 1258, such that the user can switch between differenttarget organs. For instance, as depicted, the analytics serveridentifies that the patient is receiving radiotherapy on the patient'sright breast and spine. As a result, the analytics server displays thetoggle 1258 indicating each treatment organ. The embodiment depicted inpage 1240 displays the patient's anatomy (e.g., spine or any other organdictated/requested by the user).

The analytics server may capture a separate image (e.g., at a differentcouch position) to show each treatment site alignment. Alternatively,the workflow of FIG. 11 may be repeated for each treatment site. Theanalytics server may align several organs identified in one set ofimages and then allow an analysis of the overall patient alignment basedon the individual organ alignments. Therefore, there could be different“views” of one image pair to review generated at each treatment site.

The page 1240 includes three main regions, though any configuration maybe utilized. The graphical components 1244, 1230, 1232 each display andoverlays one or more instances of reference images and acquired images(e.g., x-ray images, 2D x-ray images or 2D images reconstructed from 3D(or 4D) x-ray image (or CT images)) of the selected target organ. Forinstance, the graphical component 1244 displays cross-sectional imagesof the patient's anatomy, the graphical component 1230 displays frontview images of the patient's anatomy, and the graphical component 1232displays a side view images of the patient's anatomy. In someconfigurations, the patient's target organ may have dimensionality, suchthat showing the entire target organ may be inefficient and/orunnecessary. For instance, spinal treatments may be limited to aparticular area of the patient's anatomy. In those embodiments, and asdepicted in the page 1240, the analytics server may only display animage corresponding to the portion of the target organ to be treated.For instance, as depicted in the graphical components 1230, 1232, theanalytics server may display only the relevant portions of the patient'sanatomy.

The analytics server may display these graphical components in the samepage. As depicted, the page 1240 includes the graphical components 1234,1230, 1232 where the graphical component 1244 is larger than thegraphical components 1230, 1234. However, this configuration may bechanged such that another graphical component is larger or they are alldisplayed as the same size. In some configurations, the user mayinstruct the analytics server to only show one graphical component(e.g., images of one area or one view) at a time.

Each image displayed in the page 1240 may be one of the first image(e.g., a medical image of the patient's target organ aligned properly, areference image) and second image (e.g., current target organ, anacquired image) discussed above. For instance, the analytics server mayretrieve the first image from the patient's RT file. The analyticsserver may then instruct one or more imaging devices operatively incommunication with the analytics server to generate an image of thepatient's target organ. For instance, the analytics server may transmitan instruction to the radiotherapy machine to generate an image of thepatient (or a particular region of the patient). As a result, one ormore imaging devices associated or otherwise in communication with theradiotherapy machine may generate an image of the patient (in his/hercurrent position) and transmit the image to be displayed on the page1240. Therefore, the second image, as used herein, refers to the targetorgans current and “actual” position before shifting to the optimizedposition for treatment.

In some embodiments, the analytics server may instruct the imagingapparatus to generate periodic images of the patient. For instance, theanalytics server may transmit an instruction to medical imaging machineattached or otherwise in communication with a radiotherapy machine togenerate real-time or near real-time images of the patient, such thatthe user viewing the page 1240 can have the latest image associated withthe patient's target organ. That is, the analytics server may update thesecond image in real time or near real time.

The analytics server may display the first or the second image as anoverlay. For instance, the images displayed within the graphicalcomponent 1244 may include the first image 1242 and the second image1246. The analytics server may overlay (superimpose) the first image1242 and the second image 1246, such that the viewer can visuallyidentify misalignments and differences between features of each image.For instance, the viewer can identify that a region of the patient'sinterior (from the second image representing the patient's currentposition) does not align with the same region as indicated within thefirst image (e.g., representing the how the patient should bepositioned).

The analytics server may also display graphical indicators 1234, 1236,1238 that represent quantity of misalignment in different axes anddirections. For instance, the graphical indicator 1234 indicates thatthe target organ should be moved 0.5 mm in the direction identified byits corresponding arrow (upward direction). The graphical indicator 1236indicates that the target organ should be moved 0.2 millimeters in thedirection identified by its corresponding arrow (upwards and to theright). The graphical indicator 1238 indicates that the target organshould be moved 0.1 mm in the direction indicated by its correspondingarrow (left).

The end-user may use the tools indicated by graphical indicators1248-1256 to revise and modify the target organ's alignment (by movingre-aligning the patient on the couch). In order to better identifymisalignments, the end-user may move each image using the graphicalindicator 1248 or blend the images using the graphical indicator 1250.The end-user may also split the images using the graphical indicator1252, such that each image is separated and displayed independently.

The graphical indicator 1254 may refer to another tool for reviewing theimages. Using the graphical indicator 1254, the user may resize and/ormove a crop of one image over anther image.

In some embodiments, the user may instruct the analytics server toautomatically match the first image and the second image such thatmisalignments are visually distinct, as depicted in the graphicalcomponent 1244. The user may accomplish this task by interacting withthe graphical indicator 1256.

The end-user may also interact with the graphical indicator 1264 toretake the second image. When a discrepancy or misalignment isidentified, the user may use his/her judgment and/or the graphicalindicators 1234-1238 to realign the patient (or instruct the patient tobe realigned). For instance, the user viewing the page 1240 may instructthe patient to move in a direction that would align his/her target organcloser to the alignment depicted in the first image. The user may thengenerate a new second image of the patient's new position on the couchusing the graphical indicator 1264. The user may then reassess thepatient's re-oriented target organ using the newly generated secondimage. The user may repeat this process until the user is satisfied withthe alignment of the patient's target organ with the targetpredetermined organs alignment (e.g., first image). In some embodiments,if the user cannot visually identify misalignments, the user mayinteract with the graphical component 1256 where the analytics serveridentifies and highlights small misalignments.

When the user is satisfied with the alignment of the patient's targetorgans, the user may interact with the graphical indicator 1266 toaccept the alignment (e.g., patient's current position/alignment on thecouch). If the page 1240 is displayed as a part of a workflow-orientedseries of pages, the analytics server may move to the next stage. Theanalytics server may also transmit a prompt to one or more computingdevices. For example, the analytics server may notify the page displayedon the radiotherapy machine, physician device, or any other electronicdevice discussed in FIG. 1A. The user may also use the graphicalindicator 1266 to overwrite results displayed in the page 1240. Forinstance, if the end-user visually identifies misalignments, theend-user may overwrite the misalignment by interacting with thegraphical component 1266.

The foregoing method descriptions and the process flow diagrams areprovided merely as illustrative examples and are not intended to requireor imply that the steps of the various embodiments must be performed inthe order presented. The steps in the foregoing embodiments may beperformed in any order. Words such as “then,” “next,” etc. are notintended to limit the order of the steps; these words are simply used toguide the reader through the description of the methods. Althoughprocess flow diagrams may describe the operations as a sequentialprocess, many of the operations can be performed in parallel orconcurrently. In addition, the order of the operations may bere-arranged. A process may correspond to a method, a function, aprocedure, a subroutine, a subprogram, and the like. When a processcorresponds to a function, the process termination may correspond to areturn of the function to a calling function or a main function.

The various illustrative logical blocks, modules, circuits, andalgorithm steps described in connection with the embodiments disclosedherein may be implemented as electronic hardware, computer software, orcombinations of both. To clearly illustrate this interchangeability ofhardware and software, various illustrative components, blocks, modules,circuits, and steps have been described above generally in terms oftheir functionality. Whether such functionality is implemented ashardware or software depends upon the particular application and designconstraints imposed on the overall system. Skilled artisans mayimplement the described functionality in varying ways for eachparticular application, but such implementation decisions should not beinterpreted as causing a departure from the scope of the presentinvention.

Embodiments implemented in computer software may be implemented insoftware, firmware, middleware, microcode, hardware descriptionlanguages, or any combination thereof. A code segment ormachine-executable instructions may represent a procedure, a function, asubprogram, a program, a routine, a subroutine, a module, a softwarepackage, a class, or any combination of instructions, data structures,or program statements. A code segment may be coupled to another codesegment or a hardware circuit by passing and/or receiving information,data, arguments, parameters, or memory contents. Information, arguments,parameters, data, etc. may be passed, forwarded, or transmitted via anysuitable means including memory sharing, message passing, token passing,network transmission, etc.

The actual software code or specialized control hardware used toimplement these systems and methods is not limiting of the invention.Thus, the operation and behavior of the systems and methods weredescribed without reference to the specific software code beingunderstood that software and control hardware can be designed toimplement the systems and methods based on the description herein.

When implemented in software, the functions may be stored as one or moreinstructions or code on a non-transitory computer-readable orprocessor-readable storage medium. The steps of a method or algorithmdisclosed herein may be embodied in a processor-executable softwaremodule, which may reside on a computer-readable or processor-readablestorage medium. A non-transitory computer-readable or processor-readablemedia includes both computer storage media and tangible storage mediathat facilitate transfer of a computer program from one place toanother. A non-transitory processor-readable storage media may be anyavailable media that may be accessed by a computer. By way of example,and not limitation, such non-transitory processor-readable media maycomprise RAM, ROM, EEPROM, CD-ROM or other optical disk storage,magnetic disk storage or other magnetic storage devices, or any othertangible storage medium that may be used to store desired program codein the form of instructions or data structures and that may be accessedby a computer or processor. Disk and disc, as used herein, includecompact disc (CD), laser disc, optical disc, digital versatile disc(DVD), floppy disk, and Blu-ray disc where disks usually reproduce datamagnetically, while discs reproduce data optically with lasers.Combinations of the above should also be included within the scope ofcomputer-readable media. Additionally, the operations of a method oralgorithm may reside as one or any combination or set of codes and/orinstructions on a non-transitory processor-readable medium and/orcomputer-readable medium, which may be incorporated into a computerprogram product.

The preceding description of the disclosed embodiments is provided toenable any person skilled in the art to make or use the presentinvention. Various modifications to these embodiments will be readilyapparent to those skilled in the art, and the generic principles definedherein may be applied to other embodiments without departing from thespirit or scope of the invention. Thus, the present invention is notintended to be limited to the embodiments shown herein but is to beaccorded the widest scope consistent with the following claims and theprinciples and novel features disclosed herein.

While various aspects and embodiments have been disclosed, other aspectsand embodiments are contemplated. The various aspects and embodimentsdisclosed are for purposes of illustration and are not intended to belimiting, with the true scope and spirit being indicated by thefollowing claims.

What we claim is:
 1. A method comprising: presenting, by a server, aplurality of pages for display, each page corresponding to a stage of aradiotherapy treatment for a patient; in response to receiving anindication that a surface of the patient on a couch of a radiotherapymachine is aligned in accordance with alignment data for the surface ofthe patient, retrieving, by the server, from a radiotherapy file of thepatient, a first image of an internal target of the patient aligned inaccordance with one or more treatment attributes, wherein the firstimage is generated at a time before the patient is positioned on thecouch; receiving, by the server, a second image of the internal targetof the patient on the couch of the radiotherapy machine; overlaying, bythe server, on a first page of the plurality of pages, the first imageand the second image, wherein the first page displays a direction toposition the internal target in the second image to align with theinternal target in the first image; and when the internal target isaligned, presenting, by the server, for display, a second page of theplurality of pages corresponding to a subsequent stage of theradiotherapy treatment for the patient.
 2. The method of claim 1,wherein a difference between the first image and the second image isvisually distinct.
 3. The method of claim 1, wherein the first pagefurther comprises a graphical indicator configured to instruct theradiotherapy machine to acquire and present a third image.
 4. The methodof claim 1, wherein the first page further comprises a graphicalindicator displaying an alignment data for the patient.
 5. The method ofclaim 4, wherein the alignment data identifies an alignment instructionto match the internal target within the second image with the internaltarget within the first image.
 6. The method of claim 1, wherein thefirst page further comprises a graphical indicator configured toinstruct the radiotherapy machine to proceed to the subsequent stage oftreatment.
 7. The method of claim 1, wherein the first page furthercomprises an alignment direction for the patient.
 8. The method of claim1, wherein the first page comprises an indication of a treatment stageassociated with the patient's treatment.
 9. The method of claim 1,wherein the first page is displayed before the radiotherapy machinestarts the patient's treatment.
 10. The method of claim 1, wherein thefirst page comprises at least a third image depicting the internaltarget from a different angle than the first or the second image.
 11. Asystem comprising: a server comprising a processor and a non-transitorycomputer-readable medium containing instructions that when executed bythe processor causes the processor to perform operations comprising:presenting a plurality of pages for display, each page corresponding toa stage of a radiotherapy treatment for a patient; in response toreceiving an indication that a surface of the patient on a couch of aradiotherapy machine is aligned in accordance with alignment data forthe surface of the patient, retrieve from a radiotherapy file of thepatient a first image of an internal target of the patient aligned inaccordance with one or more treatment attributes, wherein the firstimage is generated at a time before the patient is positioned on thecouch; receive a second image of the internal target of the patient onthe couch of the radiotherapy machine; overlay on a first page of theplurality of pages, the first image and the second image, wherein thefirst page displays a direction to position the internal target in thesecond image to align with the internal target in the first image; andwhen the internal target is aligned, present for display, a second pageof the plurality of pages corresponding to a subsequent stage of theradiotherapy treatment for the patient.
 12. The system of claim 11,wherein a difference between the first image and the second image isvisually distinct.
 13. The system of claim 11, wherein the first pagefurther comprises a graphical indicator configured to instruct theradiotherapy machine to acquire and present a third image.
 14. Thesystem of claim 11, wherein the first page further comprises a graphicalindicator displaying an alignment data for the patient.
 15. The systemof claim 14, wherein the alignment data identifies an alignmentinstructions to match the internal target within the second image withthe internal target within the first image.
 16. The system of claim 11,wherein the first page further comprises a graphical indicatorconfigured to instruct the radiotherapy machine to proceed to thesubsequent stage of treatment.
 17. The system of claim 11, wherein thefirst page further comprises an alignment direction for the patient. 18.The system of claim 11, wherein the first page comprises an indicationof a treatment stage associated with the patient's treatment.
 19. Thesystem of claim 11, wherein the first page is displayed before theradiotherapy machine starts the patient's treatment.
 20. The system ofclaim 11, wherein the first page comprises at least a third imagedepicting the internal target from a different angle than the first orthe second image.